Reality Bites 17

The problem with General Practice is fundamentally one of scale

By: Information Daily Staff Writer
Published: Monday, June 8, 2015 - 12:08 GMT Jump to Comments
           

When GP Chair of NHS Cannock Chase CCG, Dr Jonny McMahon, agreed to take part in Reality Bites - The National Healthcare Conversation.

I first met Dr Johnny McMahon, the GP Chair of NHS Cannock Chase CCG in 2007. I was impressed then by his understanding of general practice, his insight into the needs of the future, and his ability to say it like it is. 8 years on and nothing has happened to change my initial admiration.

Johnny is clear that the problem general practice has is fundamentally one of scale. Practices are too small. They are too small to attract the staff they need, to offer flexible working patterns, to take on 7 day working, to meet the requirements of access, and to innovate at the pace required in the modern NHS.

The challenges general practice is facing today are unprecedented, and this means that the only way a practice can stay small and survive is by federating.

It is not just practices that are changing. The role of the GP partner, Johnny explains, has now changed. In the past, a GP partner was simply a GP prepared to buy into the premises. The payback was that they would be paid almost twice as much as a salaried GP.

This is no longer the deal. If GP partners want to continue to be able to justify the additional take home pay, then they need to be prepared to put in the additional effort that comes with commissioning, federations and all of the additional demands on modern general practice. That is the deal they are committing to.

It is hard to wear the many hats of a modern GP, Johnny admits, but that does not make it impossible. Locally, being a CCG Governing Body member and part of a GP Federation meant that the problems of conflict of interest had to be explicitly addressed.

While the system seems set on making life difficult for GPs to make the changes that are required, Johnny is clear that there is no other way, and that there is always a way through.

The future, however it may feel, remains within the gift of general practice. Johnny is clear, ‘The imagination for where general practice will go will come not from the CCGs, not from NHS England, but from the practices themselves.’

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