NHS GPs are overworked, expensive and in short supply. Beefing up the roles of other NHS staff could improve primary care
THE NATIONAL HEALTH SERVICE is free, so it is also rationed. Family doctors, known as general practitioners , act as the first port of call for patients; friendly gatekeepers to the rest of the service who refer people to specialists only if needed. But in some parts of the country, including St Austell on the Cornish coast, access to the rationers is itself now rationed.
When the four practices serving St Austell merged in 2015, it was an opportunity to reconsider how they did things. The GPs kept a diary, noting precisely what they got up to during the day. It turned out that lots could be done by others: administrators could take care of some communication with hospitals, physios could see people with bad backs and psychiatric nurses those with anxiety. So now they do. Only patients with the most complicated or urgent problems make it to a doctor.
NHS leaders hope the new workers will help practices play a more active role in their community, linking up with services provided by local authorities and charities. Each network will be responsible for a population of 30,000-50,000. The plan is that they will use data analysis to intervene early to prevent illness, and that practices will often share the new staff with others in their network.
Working in a team will nevertheless require a big shift in mindset for many doctors, particularly those in surgeries that have never before employed anyone else aside from the odd nurse. One worry is that practices will end up doing what they must to get the extra funding, but little more. There are also more practical problems. Seven in ten GPs say their practices are too cramped to provide new services, and it is not clear where some of the extra staff will be hired from.
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