GP Partnership Review – Final Report (January 2019)04/02/19
There is no single, simple solution. The challenge is about reducing workload to a manageable level; expanding the workforce to support staff, patients and the system; reducing unjustified risk to individuals; and providing a high quality, person-centred service that GPs and others working in primary care find varied and rewarding, now and in the future
Dr Nigel Watson, the independent chair of the GP partnership review, has completed his key lines of inquiry into whether the partnership model is suitable for the future of general practice. The interim report (published in October 2018) suggested that with some invigoration the partnership model could be fit for the future of general practice.
The report outlined the main difficulties faced by practices and also highlighted the role of primary care in the wider healthcare system. The following areas were identified as key challenges:
- Workload: the demand for services is ever increasing and a key reason for this is the population’s changing demographics. This trend is likely to continue with increasing numbers of over 60s having two or more long term conditions.
- Workforce: recruitment and retention are major problems, especially at partnership level. The number of GPs decreased in the 24 months from September 2016–2018. With fewer trainees looking to become partners, and more partners looking to retire in the next two to five years, the ability for the partnership model to continue seems unlikely unless this is reversed.
- Risk: being in a partnership means being exposed to unlimited personal liability. This risk is heightened for some when considering being locked into premises, especially leasehold. A separate premises review is being undertaken to see if this burden can be alleviated.
There was also the fear of “the last man standing” and managing this risk was necessary. The report recommends that “every partnership should have an up to date partnership agreement – we couldn’t agree more.
- Role of General Practice: general practice struggles to be heard in the wider NHS —primarily because they are small organisations — and are often overlooked when policy decisions are made.
The review makes seven recommendations to alleviate the tensions and challenges faced by GP partners when continuing to operate as a partnership. Capsticks will consider these recommendations in a series of upcoming articles.
The report does believe that the partnership model is the model for general practice in the future. It welcomes the shift in funding for primary care and the direction taken in the Long Term Plan that more services will be moved out of acute care and into community based care.
The current model of care in the NHS is too dependent on hospital-based care. This model is not sustainable, and we cannot move forward without change that includes general practice and partnerships at its heart.