There are a number of reasons for general practice to change – it is often small and called inefficient, with wide variations in quality from one practice to the next | PCC
There are also things GPs and patients are desperate not to change – general practice is local, personal and often delivers exceptional care as well as excellent value for money for taxpayers.
The scaled up version of general practice imagined by policymakers makes complete sense: organisations big enough to cope with changes in demand, able to expand the range of services they provide, able to benefit from economies of scale, and able to make more creative use of the wider primary care clinical workforce to free GP time and add value for patients.
However logical or inevitable big general practice may appear, practices are left with a number of questions:
- How do we grow big without losing the benefits of being small?
- What are the longer term gains and what might we have to give up for them?
- How do we retain a voice in the new bigger enterprise?
- How practical is it to share patients and workforce?
- How do we bring patients along with us?
- What about governance – who is ultimately responsible for care when patient lists are shared?
And the biggest question of all: how do we find time to make the changes we need to make when we’ve never been busier?
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