Best Practice issue 9 | Page 12

Why bother doing what are we doing in the way we are doing it? General practice, we are told by many is in a state of crisis. The real issues seem to be recruitment, retention, workload and morale. The GPC has conducted a number of surveys, as have other organisations, which would seem to back that up however it may be worth looking rather deeper to try to analyse the real problems. The first question I would ask is whether general practice itself; the actual core job, has become unattractive. When people finally become GPs they will have trained for at least 10 years, it seems very unlikely that they have spent all that time training for a job that they really don’t want to do. The job itself, being a family doctor, looking after patients from cradle to grave, being involved in a local community still exists and I will argue hasn’t really changed and is as attractive as it ever was – it has a huge number of rewards which simply aren’t found in hospital medicine. What has changed at the present is the environment; both clinical and financial which has caused a huge amount of pressure on the present workforce leading to an exodus of older GPs and the lack of retention of younger GPs. If the balance of work life remuneration in respect could be addressed I think that the present crisis could be resolved. In the longer run if the perception of General Practice was to change medical schools could start to encourage graduates to consider general practice as a viable and sensible career choice. Opinion piece So... SHORT TERM So how do practices cope with this? What is happening is that those who can manage to are reducing their Dr Jeremy Cox, commitment to patient will be speaking facing general practice at Best Practice by either starting to retire if they can or by taking up other roles if they cannot. Younger doctors are using different strategies; either not going into general practice at all or becoming locums. It is quite difficult to see how a very short-term solution can change this since the real problem is the “job” itself but some federations and super practices are attempting to extend training by offering post registrar post schemes involving patient facing and other work and rotations through practices. In the medium term the overall package needs to be made more attractive if any of the political parties targets are to be met; the latest GP survey by the GPC shows that GPs want more time per patient as the complexity of cases and age of patients has changed; they want less bureaucracy and a more stable environment with premises fit for purpose. Practices have to look at their own retention strategies perhaps as part of local federations which could look to improve practice profits through cost reductions and seeking more profitable work. They also need to find ways of valuing new GPs and working in ways that aren’t harping back to the dark ages. New GPs need to feel they are in control of their own futures and can make valuable inputs into the agenda of new ways of working. MEDIUM TERM Government changes the environment through tax and contractual changes to encourage retention and recruitment combined with federations providing new employment models. LONGER TERM The cycle will continue with general practice waxing and waning as a career choice as the economic and political environments change. Combined with a long-term strategy to change the image starting at medical school. We will: • Lighten your workload • Reduce your exposure to risk • Give you your time back Calling all GPs... And best of all we will do it for FREE! To find out more call us or come see us on our stand at the Best Practice event Tel: 0333 577 7020 12 Join the conversation @BestPracticeUK Web: www.tsfconsultants.co.uk www.bestpracticeshow.co.uk