Predicting the future of primary care in England
Visions of primary care in 2015; BMJ volume 332, pp 41-8What will English primary care look like in 2015?
The forthcoming white paper on health and community services in England will affect all of our futures, so the BMJ asked some people with an interest in general practice to predict the future.
General practices will be highly developed strategic organisations collaborating with each other in a community network, predict senior doctors at the Royal College of General Practitioners.
Their vision is for a strong and vibrant primary healthcare system that is patient centred, consistently of high quality, safe, and accountable. They urge policy makers is to build on the strengths and values of general practice, and avoid policies that run the risk of fragmenting care.
For Peter Lapsley, Chief Executive of the Skin Care Campaign, 2015 sees control of NHS budgets returned to central government and targets for access to general practitioners abandoned. Meanwhile, patients have embraced health promotion messages and regularly attend wellbeing centres, allowing doctors and nurses to spend more time with the sickest patients. The concept of "patients as partners in their own healthcare" has also become a reality.
GP Dougal Jeffries predicts a return of a system based on social values. Expenditure on weapons has been diverted to the NHS, coordination and cooperation have superseded market forces, and patients are dealt with quickly and appropriately.
For Hamish Meldrum, Chairman of the BMA's General Practitioners Committee, the future finds general practice under pressure.
Political interference has left the largely female profession feeling undervalued. The nature of general practice has also changed considerably, with larger practices offering a wider range of services and video phone consultations relieving some of the problems of access. The NHS is still, ostensibly, free at the point of use but patients have to pay for non-essential services including hotel charges in hospital.
By 2015, health care will be safe, clinically effective, and patient focused, concludes Carol Black, President of the Royal College of Physicians. She believes that patients will reject behaviours that harm health, but will continue to rely on their general practitioners to help them make decisions about health. Medical professionalism will ensure high levels of public trust.
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