A major stocktake of primary care recommends three ‘essential’ strategies for integrating primary care, and improving the access, experience and outcomes for communities.
The Fuller report makes recommendations to:
- Streamline access to care and advice for people who get ill but only use health services infrequently, providing them with more choice about how they access care and ensuring care is always available in their community when they need it
- Provide more proactive, personalised care with support from a multidisciplinary team of professionals to people with more complex needs
- Help people to stay well for longer as part of a more ambitious and joined-up approach to prevention.
The author, Dr Claire Fuller, a GP and CEO designate of Surrey Heartlands ICS, said there were real signs of genuine discontent with primary care, both from the public who use it and the professionals who work within it. At the same time, primary care teams were stretched beyond capacity, with staff morale at a record low. ‘Left as it is, primary care as we know it will become unsustainable in a relatively short period of time.
‘It is the collective judgement of the people who have engaged closely in our stocktake that the vision for integrating primary care set out in this report is achievable if we create both the conditions to enable locally led change and the supporting infrastructure to implement it,’ Dr Fuller said.
Crucial to the delivery of the Fuller vision are workforce, estates and data: national policy needs: to address the shortfall in GPs and recruitment across the wider primary care workforce; take proactive steps to address inadequate premises – around 2,000 of the 8,911 practice premises in England were identified as not fit for purpose; and introduce tools to make data sharing seamless.
RCGP chair Professor Martin Marshall described the report as ‘appropriately ambitious, given the scale of the crisis in general practice’.
He said: ‘Addressing workforce and workload pressures, improving staff morale and investing in support for change will be particularly key to achieving the report’s aspirations.’
The RCGP has published its own plan for general practice, Fit for the future: Relationship-based care that includes:
- A new recruitment and retention strategy that goes beyond the current target of 6,000 more GPs.
- An NHS-wide campaign to free up GPs to spend more time with patients by cutting unnecessary workload and bureaucracy
- Improving patients’ experience of access care by investing in a new suite of IT products, making it easier for patients to see the same GP or next available member of the team
- Returning funding for general practice to 11% of total health spend, including £1bn additional investment in GP premise.
Fuller C. Next steps for integrating primary care: Fuller Stocktake report; May 2022. https://www.england.nhs.uk/wp-content/uploads/2022/05/next-steps-for-integrating-primary-care-fuller-stocktake-report.pdf
RCGP. Fit for the future: relationship-based care; June 2022. https://www.rcgp.org.uk/policy/general-practice-covid-19-power-of-relationships.aspx