The Commons Health and Social Care Committee has announced a review into the future of general practice.  What does this mean, why would they do this, and what are the implications for the service?

The Health and Social Care Committee is a cross party committee charged with overseeing the operations of the Department of Health and Social Care and its associated agencies and public bodies (including NHS England).  It essentially has a scrutiny role.

The Committee chooses its own subjects of inquiry, which it then undertakes by reviewing written and oral evidence.  Once complete, the findings of the inquiry are reported by the Committee to the House of Commons.  The government then has 60 days to reply to the Committee’s recommendations.  The government does not have to accept them, e.g. the Environmental Audit Committee inquiry into disposable packaging recommended a 25p “latte levy” on disposable coffee cups; but the government rejected it, preferring for coffee shops to incentivise customers by offering discounts for the use of reusable cups.  However the cross party nature of the Committee, designed to build consensus across parliament, means its recommendations do still exert considerable influence.

This committee on the 16^th November launched an inquiry into the future of general practice.  Its headline focus is to examine both the challenges facing general practice over the next 5 years, and the biggest and current barriers to access to general practice.  The committee is actively seeking evidence from anyone with expertise in the area (i.e. you, if you are reading this).  The deadline for submissions, which must be no longer than 3,000 words, is Tuesday 14^th December.

It is one of 9 current inquiries the Health and Social Care Committee either has underway or that are complete and are awaiting a government response.  The others are workforce burnout, lessons learnt from coronavirus, children and young people’s mental health, treatment of autistic people and individuals with learning disabilities, supporting those with dementia and their carers, cancer services, clearing the backlog from the pandemic, and NHS litigation reform.

The inquiry into general practice will cover a range of issues (you can find the full terms of reference here), but it includes regional variation in general practice, general practice workload, and the partnership model of general practice.  The specific question in relation to the latter of these points is, “Is the traditional model of general practice sustainable given recruitment challenges, the prioritisation of integrated care, and the shift towards salaried GP posts?”.   There is also a question about PCNs, “Has the development of PCNs improved the delivery of proactive, personalised, coordinated and integrated care and reduced the administrative burden on GPs?”.

What can we make of the announcement of the inquiry into the future of general practice?

The first point to note is the timing of the announcement.  It has come at a point where there has been considerable media and public attention to the challenges around access to general practice, and is also hot on the heels of the announcement of a ballot for industrial action of GPs by the BMA in response to NHS England’s recent publication on improving access and support for general practice.  It does not seem unreasonable for this to have been picked up as a point of concern by the Committee at this point in time.

The second point to note is that the Chair of the Health and Social Care Committee is Jeremy Hunt.  Jeremy Hunt appears to be enjoying his role as a backbench GP, able to chair this committee from a position of considerable knowledge, particularly in terms of how he can make life as uncomfortable as possible for the government.  His own response to the NHS England document was that it “won’t turn the tide” for GPs, and this seems to be reflected in some of the wording of the terms of reference, e.g. “to what extent does the government’s and NHS England’s plan for improving access for patients and supporting general practice address these barriers” (to access to general practice) when it is already clear to everyone that it does not.

There will be the more cynical who assume this is a back door attempt to end the independence of general practice and shift practices into the main body of the NHS, or conversely to privatise things further by shifting all remote and telephone consultations to digital first providers to “reduce pressure” on practices.  And while it does seem odd to want to look at the partnership model of general practice only a few years after the 2019 review by Nigel Watson, the cross party nature of the committee, along with the methodology of collating evidence from as wide a group of experts as possible, does make this seem unlikely.

Whilst it is hard for anyone in general practice to trust anything led by Jeremy Hunt, my sense is the best course of action would be for as many of those working in general practice as possible to give evidence and provide their views on the questions asked and what is needed going forward.  It feels like a genuine chance to be heard, and is a welcome change from the recent policy directives received from NHS England which have had little or no consultation at all.