General Practice: The Heart Of The Nhs

General practice is often hailed as the jewel in the crown of the NHS.1 However, a decade of underfunding, increasing patient complexity, issues with recruitment, and rising bureaucracy have led to a loss of its lustre. Amid a drive to move care into the community we continue to have the most stressed GPs in the Western world.2 This is doubtless impacting on junior doctors and medical students contemplating a career in general practice, as highlighted by Professor Wass’s recent report By Choice — Not by Chance .3It is general practice that makes the NHS one of the world’s most cost-effective health services, yet spend on general practice continues to be outstripped by that on hospital outpatient clinics alone. Never before has the need for an optimised version of general practice felt more critical to the long-term sustainability of the NHS. As Roland and Everington write, ‘If general practice fails, the whole NHS fails.’ 4The General Practice Forward View (GPFV) was launched in April 2016 by NHS England and Health Education England, with the support of the RCGP. It is a complex plan for a complex set of issues that have besieged primary care for too long.5 NHS England is backing this plan with a 14% real-terms increase in funding to support general practice services over 5 years. This is almost double the investment going into other parts of the NHS, and a notable change from a system that has historically prioritised the acute sector. At a time of austerity, this remarkable shift seeks to both stabilise …