Special guest speaker, Dominic Hardy (National Director of Primary Care)
England’s demographics are radically changing and there is now a much larger population of over 65 year-olds, which has an impact on primary care. Compared to the average rate of a 30 year-old, over 75s use three times more resources, and over 80s five times more. The increasing older population has also led to a 50% increase in dementia in the past decade.
Another change is that of British social attitudes. GP satisfaction has fallen in 2017 and it is hard to fully understand why. Within London, there is an overlap with the introduction of GP at Hand, the first digital service that provides video appointments. Since November, 25,000 people have registered and a further 38,000 are waiting to join. It seems that people are no longer content in traditional GP appointments, which could explain the satisfaction drop.
One of the key challenges is there are too few GPs with an estimated 39,500 GPs required. In 2015, there were 34,500, but this fell to 33,300 in 2017. There needs to be an increase in training places, medical schools need to promote GP placements, and senior GPs should be used to encourage and support trainee GPs. If nothing is done, it will be difficult to get 5,000 more doctors in general practices. If so, the complexity of patients with multiple long term conditions suggest that there won’t be enough skilled people who can help these patients stay out of acute settings for long.
Turning to age and gender, there are more female doctors coming into the workforce than male doctors, but they tend to leave at earlier stages of their careers. Retention at all levels is therefore key. For those who retire, it may be possible to get them back in for a few sessions to mentor and support the younger GPs.
However despite these challenges there are a number of positive changes in train, with the national role out of the 10 high impact changes. The aim is to put these actions in as many practices as possible over the next few years, and early resulting showing a significant release of senior partner time.
There are also many who believe that pier groups would encourage more young doctors to become GPs. Recently a new programme was set up in Cambridge, which has been spreading to other cities. It brings 50-60 GPs together for 5 sessions, where they learn leadership skills and have the opportunity to build their own support network.
Finally, GPs’ attitudes towards their general practice have changed. Few believe that their future is working in or owning small stand alone practices and many are considering collaborating with surrounding practices so they can share staff, deliver integrated services and employ more specialists working across a wider area.