Health think tanks the King’s Fund and the Nuffield Trust argue that GPs are “caught on a treadmill” of direct patient care and need support and incentives to develop a wider range of services.
They recommend the development of a new alternative contract, alongside the existing general medical services (GMS) contract, enabling groups of practices to take “collective responsibility” for population health.
The report reflects concern among health experts that the new local authority public health system does not have sufficient funding or capability.
NHS England, it argues, must develop a national framework to define “the outcomes and overall vision for primary care in relation to the services it provides and its place within the wider health and social care system.”
Monitor, it argues, should ensure that collaborations between GP practices and other organisations to support public health are not prevented by the rules enforcing “choice and competition”.
It is “a pressing priority” for GP practices to develop larger networks that could offer extended services, the report says – including rapid local access to specialist advice, and better care for people with multiple long-term conditions.
One recommendation is an investment fund to enable practices to free up one day a week for a number of weeks, allowing it to undertake “detailed personalised care planning for its frail elderly population”.
Judith Smith, Director of Policy at the Nuffield Trust, commented: “General practice in England is under significant strain. Radical change will depend on support, incentives, and GPs feeling that they have permission to test out new approaches to the delivery and organisation of care.”