Reforms threatened by GPs\' refusal to embrace change
A leading government sustainability expert has accused GPs of being too slow to adopt technology and embrace the ‘care closer to home’ agenda.
David Pencheon, director of the NHS Sustainable Development Unit (SDU), told delegates at last week's IHEEM Healthcare Estates Conference that as GPs will play a more central role in healthcare delivery and commissioning moving forward, they will have to find new ways of working.
He said: "I asked a number of GPs what percentage of their time was spent on telephone consultations, rather than face-to-face appointments or home visits, and the answers ranged from 60% to nothing.
"We are not talking modern technology here. This is about the telephone, which was invented years ago. We need to look at this and decide how we are going to deliver healthcare in the future and how we are going to look after thousands of patients with diabetes, for example. We do not want to bring them all into hospital. Things have got to be more flexible, but we are very slow to adopt new technology."
Jo Webber, deputy director of policy at the NHS Confederation, said that to ensure the service was sustainable, a balance needed to be found between providing direct patient care and empowering people to take more responsibility for their own health and wellbeing.
She added: "People expect a 24/7 service that is digitally enabled. People also want services that are personally tailored and some of the ways we currently deliver services are not personal.
"However, as much as we put remote systems in, we also need the personal touch of someone being there talking to people. We need to find the right balance between the 0% and 60% David was speaking about.
"Sustainability and high quality have to go hand in hand. We can simply slice services, but that will not get us where we need to go. We need to redesign services right across the system."
And this will mean GPs working much more closely with acute care trusts and community health and social care teams.
Nigel Edwards, a senior fellow at the King's Fund health thinktank and a director at healthcare consultancy, KPMG, said: "The models of care and business models are not futureproof as they stand."
And Duane Passman, 3T programme director for the estates and facilities team at Brighton and Sussex University Hospitals NHS Trust, added: "There is an opportunity to think more strategically about models of care in the future. We need to look at what is possible across the whole care pathway. We can't just cherrypick.
"With the Government reforms, there is an opportunity to look at how we commission all services and how primary care providers can affect that. Then we have to look at how we support that in the best way."
Essentially this will mean a lesser role for hospitals and a much greater role for GPs and community organisations.
Paul Kingsmore, IHEEM president, said: "Some key themes have emerged particularly around patient-centred care, clinical leadership of services and a focus on clinical outcomes. These changes have driven the Government's proposed commissioning strategy.
"In practical terms it means greater productivity and more care at home. We have talked about it for the last 20 years, but there is now a much bigger drive for that. Improving care is also a key theme and reshaping care delivery will be a fundamental challenge."