Changes in the Roles of Health Care Professionals in Primary Care in England's National Health Service

In an article published in the Journal of Ambulatory Care Management, Dr Sonia Kumar and I discuss the change in the roles of doctors and other health professionals in England’s NHS. Primary care in England has seen a slow but steady expansion in the roles and numbers of non-medical health care professionals over the last 50 years. In the next 5 to 10 years, the use of non-medical professionals will expand rapidly in primary care, with currently unknown consequences for patient outcomes and England’s NHS. Doctors in England will find their traditional professional autonomy slowly decreasing as they increasingly work in multi-professional teams; and the education and professional development of our medical students and doctors need to change to reflect these new ways of working.

A further challenge (and opportunity) for doctors arises from the rapid advances we are seeing in information technology. Through the Internet and Web sites such as NHS Choices, patients in the United Kingdom now have easy access to medical information. We are also now seeing developments in artificial intelligence (AI) leading to alternative routes for accessing medical and health promotion advice. For example, the NHS has now begun trialing AI-based “chatbots” that will be used to offer health advice to patients when they contact the NHS telephone advice line (NHS 111) for medical advice. If these trials are successful, we may see a rapid development in the capabilities and use of AI-driven health chatbots in England and elsewhere.