We all have questions about the future of general practice. In his latest blog Ben discusses some of these key conundrums and introduces an exciting opportunity where you could be involved in developing some of the answers…

What is the future of general practice? What will it look like? Will we still have local GP practices? Will GPs continue to do what they are doing now? These are big questions, and probably ones we don’t spend enough time thinking through.

For most of us, general practice has always been there. It is one of only two fixed points of our health service (along with hospitals). I have met many GPs who describe themselves as being on a ship that is sinking, and they can’t see any way that disaster can be averted (other than a serious investment of funding, which seems unlikely in this economic environment and with this government). They urge each other to get off the ship (Australia, retirement, locum), and as a result the number of GPs is falling, despite best efforts to increase it by 5000.

The fixed nature of the GP practice means it can be hard to envisage a new future for the service. I have previously argued that general practice requires more than incremental change at the individual practice level, and that a more radical transformation is needed. But what will the nature of this transformation be? We know what we need to change from, but what we need to change into is less clear.

There are different views about the future. I have met some who are 100% certain that scale is the answer to general practice. They talk about it as being self-evident (which isn’t an argument), and say it with such conviction that many go along with them without careful questioning. I have talked about the potential benefits of operating at scale (essentially: lower costs; higher income; ability to manage demand; and readiness for the future), but have always been clear that these benefits are not automatic, and that they only come by making the changes not possible at a smaller scale.

If big really is the answer, then how big? Here we do have a divergence of answers. The primary care home model is clear that populations of 30-50,000 are what is needed. But on the other hand, Mark Newbold, Managing Partner of super practice Our Health Partnership, recently told me that the full benefits of scale required a population of over 400,000. Now, those two models are looking at two different things – the former is about redesigning local care, and the latter about reducing costs (broadly) – but just the diversity of answers to the “how big” question makes the future feel more complicated than simply “bigger”.

Some are adamant that new models of care are the answer. One GP was clear with me on Twitter recently, “ACO/MCP are the future of NHS and community care. Call them what you want but GP HAS to be core and influential within them”. In episode 66 of the General Practice Podcast Tracey Vell, LMC lead in Manchester and intimately involved with the development of the ACO there, started to describe how general practice would look differently within the new models of care. In this scenario, scale is needed primarily for practices to be able to partner with the rest of the system.

And what about the impact of technology? How long will it be before we no longer go to the doctor, but the doctor (virtually) comes to us? We are now tiptoeing over the boundaries between health and social care, through the introduction of social prescribing and the like – is that just the beginning? Will surgeries develop from health centres into something more akin to community centres? Has the general practice practitioner already been replaced by the general practice team? How will the shortage of GPs shape the future of the primary care model?

These are all questions we are going to be discussing in our first ever live event. We are bringing together some of the most interesting guests (see the Programme 18.8.18.pdf">here) we have had on the podcast to learn from their different experiences of re-shaping general practice, often in very different ways, and to debate what the future of general practice will look like and how it will develop.

If you are interested in understanding what the future of general practice will look like, how we will get there, and in contributing directly to the debate then register for this conference today. The future of general practice remains uncertain, but this is a chance to develop a compelling and coherent view of what that future will be.