Primary care based registration with a GP practice must be supported, UK

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 25 Nov 2005 - 0:00 PDT

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Primary care based registration with a GP practice must be supported and valued, the Royal College of General Practitioners has stated in its response to the White Paper on Health and Community Services. Registration has brought with it personal and organisational continuity of care, comprehensiveness and co-ordination of care particularly for patients with co-morbidity.

The RCGP response urges the Government to place primary health care teams at the heart of their future agenda and to promote policies that build on the strengths and values of general practice. The response contains proposals for primary care development.

It states that patients expect their GP to coordinate and orchestrate their care, to be their navigator through an increasingly complex NHS with its multiple providers, points of entry and choice. Navigation is more than simply providing information; it is a complex and skilled function that requires shared decision making with patients, particularly those with co-morbidity, in guiding them to obtain care that best meets their needs.

The RCGP response also outlines that both patients and GPs have raised their concerns about the fragmentation of care and that the unintended consequence of reforms might be to worsen health inequalities. The RCGP urges the Government not to fragment care by breaking up services into 'disease categories' which different providers could then compete for. With multiple providers in the NHS and multiple points of first contact care there is a risk of fragmentation of patient experience and discontinuity of care.

The College expresses concern that reform policies may also run the risk of exacerbating health inequalities. The College would like to emphasise the importance of prioritisation of care according to clinical needs of patients and the concept of social solidarity (that the benefits of healthcare are equitably distributed and that public resources are being used efficiently for the good of all). Evidence exists of poor health outcomes and access to services in both inner cities and rural areas and the RCGP calls for improvements to general practice in these challenging areas.

With patients continuing to push for services to be delivered closer to home the White Paper should work on the principle that patients should only go to hospital when they really need to be there, for example, due to an acute, major illness or for a specialised procedure. Where possible all other care should be delivered in the community.

Dr Mayur Lakhani, Chairman of the Royal College of General Practitioners, states in his covering letter to the Secretary of State for Health: "General practice is dynamic, innovative and concerned for peoples' well being. We want to be at the forefront of primary care development and hope that the White Paper will give us the support to deliver even better patient care. The major education and training function of primary care must also be valued supported."

The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the "voice" of GPs on issues concerned with education; training; research; and clinical standards. Founded in 1952, the RCGP has over 23,000 members who are committed to improving patient care, developing their own skills and promoting general practice as a discipline.

Promoting excellence in family medicine:
http://www.rcgp.org.uk

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