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
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