General practice: a better way forward?

This article is a contribution to the current debate about the future of general practice. Present rhetoric emphasising under-resourcing is disappointingly one-dimensional and is hindering exploration of alternative solutions. Workload is a major problem. Demand and expectations have risen substantially and an ageing population has brought increasing comorbidity. Early discharge and the devolution of more follow-up care to the community have also added to the responsibilities carried by primary care teams. GPs are reporting high levels of stress; morale and job satisfaction are lower than they should be. Retention of doctors is suboptimal and recruitment worryingly low. The administrative burden associated with the Quality and Outcomes Framework (QOF) is burdensome and often to no good purpose. Many patients report outstanding care from individual GPs and from practices generally. However, not all care is good, and there is noticeable public disenchantment on a number of fronts. Patients report real difficulty accessing GPs …