When Jeremy Hunt, the Secretary for State for Health in England, presented his ‘New Deal for General Practice’ in June 2015, he described general practice as the jewel in the crown of the NHS. Many general practitioners (GPs) though will not be reassured by his statement. Despite Jeremy Hunt’s words of support, the future for GPs, their teams and their patients looks very uncertain. It is hard to see how planned levels of funding for the NHS in England can sustain a readily accessible, high-quality primary care service. It seems likely that primary care in England will increasingly be delivered by non-medical professionals, such as pharmacists, nurses, physician assistants and health care assistants. The acceptability to patients – and the impact on quality of care, patient outcomes and the other parts of the NHS – of this model are all unknown. An alternative scenario is that we gradually move to a ‘two-tier’ primary care system with those patients who can afford to do so paying to see a medically qualified GP. Read more in the London Journal of Primary Care.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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