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#GPforwardview#GPforwardview
Dr Robert VarnamHead of General Practice DevelopmentNHS England
@robertvarnam
england.nhs.uk/gpfv
www.england.nhs.uk @robertvarnam
UK general practice is one of the world’s most comprehensive embodiments of the founding principles of primary care…
Personal care built on a relationship from cradle to grave
Community based responsible for prevention and care of a registered population
Holistic perspective understanding the whole patient not just a disease
Comprehensive skills to diagnose & manage almost anything
Personal and population-orientated primary care is central … if general practice fails, the whole NHS fails. Simon Stevens, General Practice Forward View
#GPforwardview
Pressures on general practice
↑ population
↑ consultations
↑ complexity
↑ costs
↓ relative funding
↓ relative workforce
www.england.nhs.uk @robertvarnam
Specialists
Non-specialist / failed consultantGatekeeper / door-holderKing of my castleIt’s all in me
Community services
www.england.nhs.uk @robertvarnam
Community services
Specialists
Non-specialist / failed consultantGatekeeper / door-holderKing of my castleIt’s all in me
Excellent continuity (by default)
The GP is there for everything
Complex care often disjointedGPs professionally isolated and undervaluedThe GP is there for everythingBiopsychosocial needs often met in medical wayOverdiagnosis & overtreatment
GPs & patients have been imprisoned within the walls of a castle that is too small.
www.england.nhs.uk @robertvarnam
Self Care
Broader skillmix
Self management /
social prescribing
Emergencycare
Collaborationwith specialists
At scale
Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
www.england.nhs.uk @robertvarnam
Self Care
111 Online and 111 Hubs
nhs.uk
Community pharmacy
Advanced Nurse Practitioner
Physician Associate
Physiotherapist
Clinical Pharmacist
Minor ailment service
Mental Health Therapist
Broader skillmix
Patient Activation
Apps and wearables
Self management /
social prescribing
Community based care and support
Peer support Welfare advice
Health coaching
Emergencycare
Collaborationwith specialists
Specialist support
Enhanced Advice and Guidance
At scale
Specialist services
Communityservices
Accesshub
Holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
www.england.nhs.uk @robertvarnam
Knowledge, skills, confidence and support
More care close to home
Empowered to play a greater role in staying well and caring for themselves, with access to comprehensive responsive care close to home.
Flexible access to the right person at the
right time
#GPforwardview
The problems
#GPforwardviewwww.england.nhs.uk/gpfv
www.england.nhs.uk @robertvarnam
Self Care
Broader skillmix
Self management /
social prescribing
Emergencycare
Collaborationwith specialists
At scale
Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
What areour priorities?
#GPforwardview
www.england.nhs.uk/gpfv
england.nhs.uk/ourwork/gpfv/gp-indemnity/england.nhs.uk/ourwork/gpfv/resilience/
bit.ly/MCPframe1