Are Integrated Care Systems doomed?

Integrated Care Systems are being hailed as the future of Primary Care. But are they doomed to be yet another forgotten reorganisation like FHSAs, PCTs and CCGs? Politicians seem to give very fixed prescriptions about how best to improve the health of our nation. They always talk warmly about how they appreciate front line staff … Read more

Swimming against the tide

Some people are saying that GPs would be better off as a salaried service, being employed by hospital trusts or private contractors. It feels like swimming against the tide to stay with the current GMS contract even though that gives us stability and has to be nationally negotiated. Rather than just disagreeing I want to … Read more

Guerrilla General Practice

Throughout my career people have been telling me that Partnerships and Personal General Practice were doomed. They said I couldn’t just carry on being a local GP and needed to be absorbed into a big organisation which would run things because that was more efficient. Being somewhat sceptical, we decided to carry on as we … Read more

The Infinite Game of General Practice

Everyone knows how a Finite Game works. Like a football or tennis match, you know the players, how to score and how long it will last. The game finishes, a winner is announced, and the players go on to new games. An Infinite Game(*) is different. Players come and go, and your objective is to … Read more

How Not To Fix General Practice

In General Practice (and other parts of the Health Service) there is a natural circle of Need and Capacity. When there is unmet need it shows up as Demand and this is what usually drives increases in Capacity. However, there is a delay while capacity meets the need and politically it may be tempting to … Read more

What comes after COVID?

Coronavirus has probably done General Practice a favour. Of course it has been hard and scary being on the front line when the entire country is in free fall trying to cope with something which reaches to the core of our society. But rarely has there been a disease which has forced the NHS to … Read more

Has Coronavirus changed General Practice for ever?

There is no doubt that General Practice has changed remarkably since the start of March Use of telephone and video consultations have become the norm. All calls are triaged. Practices are routinely open on Bank Holidays. There has been a dramatic reduction in use of locums. Local support groups have been mobilised. But these have … Read more