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a doctor consulting young lady imageJune 12 2018

The King’s Fund has developed a five-part model for a general practice service of the future that renews the focus on relationships and community.

At the heart of the model are what it believes are the core attributes of general practice are:

  • person-centred, holistic care;
  • accessible care;
  • continuity of care;
  • co-ordination of care;
  • community focus.

In designing its model for the future, it said: “Any new model of care for general practice will need to include all five core attributes of general practice. Models that focus on just one of these at the expense of the others risk providing a less effective and equitable service.”

The authors of the King’s Fund report “looked at national and international literature and spoke to primary care leaders in the UK and internationally.” They assessed a range of different general practice delivery models “and shortlisted those we felt could offer most insight for English general practice. 

“Where models were too new to have been formally evaluated, we carried out telephone and face-to-face interviews to ask more questions about the model and identify any lessons learnt during the implementation phase. We used this information to develop a set of principles that might guide the development of new models of care for general practice as part of whole-system redesign.”

Important common design themes, identified from the range of practice models, include:

  • building and maintaining strong relationships;
  • a shift from reactive to proactive care;
  • developing skill-mix;
  • using technology.

“While more resources are still required, the challenge is for practices to have the organisation and structure to enable all these elements to be in place, while having the flexibility to find the unique ‘sweet spot’ across these dimensions for each individual patient,” said the authors.

“Delivering patient-centred and holistic care requires general practice to be at the heart of the development of new models of care and integrated care systems across the NHS. These models and systems should start with individuals and families, and the communities in which they live, and general practice must maintain its position within these communities.”

Responding to the report, the RCGP’s Chair, Professor Helen Stokes-Lampard, said: “GPs and our teams have always been at the forefront of innovation in the NHS. Across the country we are already working differently to retain the key features of our general practice, as highlighted in this report, including continuity of care, a person-centred approach to care and easily accessible care, close to home in the community.

“We know that these are also the things our patients value about general practice, and why GPs are consistently rated amongst the most trusted healthcare professionals in the NHS. GPs are certainly not scared of change, but we do need the support and resources to implement change effectively, in the best interests of patient care, and ultimately the wider NHS.”

Links:
The King’s Fund announcement and link to download report      
RCGP response             

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