With around 90% of all NHS patient contacts, we have more interaction with primary care than any other service. For many of us it’s on our high street, down the road, or just around the corner.
But the needs of our population have changed dramatically since the establishment of the health service in 1948. Our primary care services are now looking fragile and under a great deal of pressure, in the face of increased demand, ageing infrastructure, and workforce shortages. We must act now to change the way we do things so that primary care is sustainable and fit for the future.
To bring about real change, we need to change the way health services are organised and delivered. We’re working to deliver care in communities with a mixture of nurses, doctors and other health workers linking in with other public services, such as housing and police. We’re strengthening primary care provision so more people can remain in their home rather than being admitted to hospital. To bring all this together, locality care organisations, made up of all health and social care providers in the area, have now been set up in most localities.
We know that a significant number of our GP practices are based in buildings that are not fit for purpose and this must be addressed. We will be reviewing all premises to understand how we can make full use of all public sector buildings and other community spaces. At the same time, we need to consider if any changes need to be made so that integrated services can be provided from a single site, offering patients a more streamlined service.
Making greater use of technology will make a big difference to how people access primary care, especially GP practices. Many patients can already go online to book appointments, request repeat prescriptions and view their practice record – we want to expand this even further. Digital technology can also allow records to be shared between different providers of health and social care, helping us to provide better, more coordinated care across organisations to tackle multiple and complex health needs. We will look at rolling out online real time consultations as an alternative to face to face appointments to improve access to advice and treatment as well as digital solutions to promote healthy living and self-management of health conditions. Most importantly, people will have more choice in how they access services and it will be quicker and easier here in Greater Manchester.
The provision of urgent and emergency care has a real impact on how well the health and care system as a whole can respond to people’s needs. Primary care is well placed to provide a quick response to healthcare needs, early intervention on potentially serious conditions, and timely reassurance where needed. In line with national requirements, we’ve worked to improve access at GP practices. People can now book routine and urgent appointments on any day of the week, including evenings and weekends, anywhere in Greater Manchester. In total, this amounts to an additional 1,500 hours from GPs, nurses, health care assistants and pharmacists during evenings and weekends. In addition, we’re working to make urgent and emergency care more joined up, developing a region wide eye care service, and improving dental care for young children.
But we will struggle to deliver any of these changes unless we can develop a workforce that is fit for the future. More and more GPs are choosing to work part time or leave the profession entirely with numbers dwindling. To try and tackle the problem, we’re supporting the establishment of schemes and initiatives that enable GPs to continue working in the local area, through promoting new ways of working and offering additional help. Bringing other healthcare professionals, including pharmacists and physiotherapists, into practices will also increase capacity and bring a wider mix of skills to primary care. The development of an expanded primary care team will see practices working more closely with other organisations, such as NHS trusts and those from the voluntary sector, to enhance care by allowing quicker access to a range of health workers in the community. This can mean faster recovery or more effective management of a patient’s health condition.
How primary care changes and adapts to deal with a changing world and new challenges will be about local decision making too. Local communities, neighbourhoods, and localities will know best what works for them and will best meet the needs of their population.
And of course, patients have a part to play too. People and communities must take charge – and responsibility for – managing their own health and wellbeing, whether they are well or unwell. We need to support people in really understanding how they can prevent ill health, manage health conditions, and find the right support in their local area. In this way, we all have a role to play in creating a primary care service that will last another 72 years (and counting).