1. Dr Robert Varnam Head of General Practice Development NHS England @robertvarnam
england.nhs.uk/gpfv
#GPforwardview

2. Personal care built on a relationship from cradle to grave
UK general practice is one of the world’s most comprehensive embodiments of the founding principles of primary care…
Holistic perspective understanding the whole patient not just a disease
Personal care built on a relationship from cradle to grave
Comprehensive skills to diagnose & manage almost anything
Community based responsible for prevention and care of a registered population
Personal and population-orientated primary care is central …
if general practice fails, the whole NHS fails. Simon Stevens, General Practice Forward View

3. Pressures on general practice
↑ population ↑ consultations ↑ complexity ↑ costs
↓ relative funding
↓ relative workforce
2% population growth /yr
2.5% inc in consultations every year since 2007
GP numbers grown by 5,000 FTEs in past 10y - but hospital consultant numbers have roughly tripled

4. Non-specialist / failed consultant Gatekeeper / door-holder
King of my castle
It’s all in me
Specialists
Community services

5. Non-specialist / failed consultant Gatekeeper / door-holder
King of my castle
It’s all in me
Specialists
Community services
Excellent continuity (by default)
The GP is there for everything
Complex care often disjointed
GPs professionally isolated and undervalued
The GP is there for everything
Biopsychosocial needs often met in medical way
Overdiagnosis & overtreatment
GPs & patients have been imprisoned within the walls of a castle that is too small.

6. Self management / social prescribing
Broader skillmix
Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
Emergency
care
At scale
Self Care
Self management / social prescribing
Collaboration
with specialists

7. Self management / social prescribing
Broader skillmix
Holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
Advanced Nurse Practitioner
Physiotherapist
Physician Associate
Mental Health Therapist
Clinical Pharmacist
Minor ailment service
Emergency
care
At scale
Access
hub
Community
services
Specialist services
Self Care
Self management / social prescribing
nhs.uk
Collaboration
with specialists
111 Online and 111 Hubs
Patient Activation
Health coaching
Specialist support
Enhanced Advice and Guidance
Community pharmacy
Apps and wearables
Community based care and support
Peer support
Welfare advice

8. Flexible access to the right person at the right time
Empowered to play a greater role in staying well and caring for themselves, with access to comprehensive responsive care close to home.
Knowledge, skills, confidence and support
More care close to home

9. The problems

10. Stabilisation AND transformation
The START

11. Self management / social prescribing
Broader skillmix
Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.
Emergency
care
At scale
What are
our priorities?
Self Care
Self management / social prescribing
Collaboration
with specialists

12. www. england. nhs. uk/gpfv england. nhs
england.nhs.uk/ourwork/gpfv/gp-indemnity/ england.nhs.uk/ourwork/gpfv/resilience/ bit.ly/MCPframe1