The late, great David Bowie sang, “Ch-ch-ch changes. Turn to face the strange…” And goodness knows the NHS knows about change. There have been umpteen re-organisations of the NHS. Arguably the most seismic changes for general practice in recent times were the introduction of payment by results, with QOF, in 2004 and more recently the Health and Social Care Act, leading to the creation of Clinical Commissioning Groups.
British general practice has shown over the years that it is adaptable. GPs and their practices have moulded, bent and stretched themselves to attain targets, provide commissioners, extend services, meet demand, submit to quality control, improve data recording and become more defensive. Change after change after change. It is perhaps no wonder that many talk of a crisis in general practices as coping with change is tiring, demoralising and can easily alter one’s focus.
We are in an age of unprecedented demand, coupled with an atmosphere of financial austerity; yet we are still expected to adjust to upcoming changes. The Five Year Forward View and the General Practice Forward View published by NHS England are roadmaps for further change. What glimpses we have had of the much-whispered about contract to come in 2017 hints at yet more change to the way that we work. The push to form a Birmingham and Solihull “Strategic Footprint” to form the basis of integrated care implies the need for yet more change in order to access funds from government.
It strikes me that working flat out, at maximum capacity is not necessarily the best place to be psychologically, or practically, in order to cope with change. I feel that I almost need someone scanning the horizon for the upcoming changes, evaluating them, working out what they mean to me and what is the best way for me and my practice to adapt, yet again.
Therein lies one the advantages of membership of Our Health Partnership. By virtue of the fact that we have a strategic board, with time set aside to develop tactics to tackle the changes that are round the corner for general practice. We also have the capacity to scan the horizon, evaluate the changes needed if it fits with our vision, identify the skills and resources needed and produce a coherent action plan for all partners. As a collective super-partnership we are not only in a better position to influence local health policy as well as being able to provide a co-ordinated response as a single organisation.
The changes will no doubt keep coming, and will likely always be out of our control. However, together we will have a better chance of adapting and absorbing them in ways that mean our patients still receive great care and we all still enjoy our jobs.
Samir Dawlatly is a GP partner at Jiggins Lane Medical Centre and Board Member of Our Health Partnership. The views expressed here are his own and don’t necessarily represent that of any organisation he works for.