#GPforwardview#GPforwardview

Dr Robert VarnamHead of General Practice DevelopmentNHS England

@robertvarnam

england.nhs.uk/gpfv

www.england.nhs.uk @robertvarnam

UK general practice is one of the world’s most comprehensive embodiments of the founding principles of primary care…

Personal care built on a relationship from cradle to grave

Community based responsible for prevention and care of a registered population

Holistic perspective understanding the whole patient not just a disease

Comprehensive skills to diagnose & manage almost anything

Personal and population-orientated primary care is central … if general practice fails, the whole NHS fails. Simon Stevens, General Practice Forward View

#GPforwardview

Pressures on general practice

↑ population

↑ consultations

↑ complexity

↑ costs

↓ relative funding

↓ relative workforce

www.england.nhs.uk @robertvarnam

Specialists

Non-specialist / failed consultantGatekeeper / door-holderKing of my castleIt’s all in me

Community services

www.england.nhs.uk @robertvarnam

Community services

Specialists

Non-specialist / failed consultantGatekeeper / door-holderKing of my castleIt’s all in me

Excellent continuity (by default)

The GP is there for everything

Complex care often disjointedGPs professionally isolated and undervaluedThe GP is there for everythingBiopsychosocial needs often met in medical wayOverdiagnosis & overtreatment

GPs & patients have been imprisoned within the walls of a castle that is too small.

www.england.nhs.uk @robertvarnam

Self Care

Broader skillmix

Self management /

social prescribing

Emergencycare

Collaborationwith specialists

At scale

Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.

www.england.nhs.uk @robertvarnam

Self Care

111 Online and 111 Hubs

nhs.uk

Community pharmacy

Advanced Nurse Practitioner

Physician Associate

Physiotherapist

Clinical Pharmacist

Minor ailment service

Mental Health Therapist

Broader skillmix

Patient Activation

Apps and wearables

Self management /

social prescribing

Community based care and support

Peer support Welfare advice

Health coaching

Emergencycare

Collaborationwith specialists

Specialist support

Enhanced Advice and Guidance

At scale

Specialist services

Communityservices

Accesshub

Holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.

www.england.nhs.uk @robertvarnam

Knowledge, skills, confidence and support

More care close to home

Empowered to play a greater role in staying well and caring for themselves, with access to comprehensive responsive care close to home.

Flexible access to the right person at the

right time

#GPforwardview

The problems

#GPforwardviewwww.england.nhs.uk/gpfv

www.england.nhs.uk @robertvarnam

Self Care

Broader skillmix

Self management /

social prescribing

Emergencycare

Collaborationwith specialists

At scale

Population wellbeing management and holistic person-centred care provided by a multiprofessional team led by the GP, supported by at-scale collaboration and efficiencies.

What areour priorities?

#GPforwardview

www.england.nhs.uk/gpfv

england.nhs.uk/ourwork/gpfv/gp-indemnity/england.nhs.uk/ourwork/gpfv/resilience/

bit.ly/MCPframe1