Healthcare reform and new technology will mean the provision of primary care services will be radically different in 10 years, practice managers agreed at the MiP London conference yesterday.
At the beginning of his keynote presentation, Dr Kieran Sweeney, a GP and senior medical lecturer, asked the audience of several hundred practice managers to give a show of hands to indicate how they felt primary care would change in a decade.
Not a single manager felt that primary care would remain as it is today in a decade's time. A few thought that services would change but the over-riding structure would be essentially the same. The overwhelming majority believed primary care would be "radically different" from the current model.
Dr Sweeney spoke of how the dual effects of changing health policy – such as a focus on patient choice – and emerging IT and healthcare technology would alter the primary care landscape significantly over the coming years.
For instance, he said telemedicine would play an increasing role in the provision of services to the extent that many patients with chronic illnesses could self-monitor and liaise with their practice without needing to book an appointment – or even speak to a doctor.
And the impact of competition and a drive for larger health centres or polyclinics, encompassing a wide range of services that would mean patients could receive tests and diagnostics on the same day that they presented, would result in smaller local practices diminishing.
In response, one practice manager said that such changes could mean that continuity of care and the ability to see the same local doctor, highly valued by her patients, would be threatened. Dr Sweeney, however, did not agree that continuity of care would be so highly valued by all patients, as many would prize convenience and access over the ability to see the same doctor.
Not all practice managers were gloomy about primary care change – in an open question-and-answer debate session later in the day, one manager was encouraged by private organisations such as Virgin Healthcare entering the fray, and was disappointed with an unwillingness of many GPs to embrace change.
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Do you think primary care will be radically different in 10 years? Are you excited or gloomy about the prospect of change? Your comments: (Terms and conditions apply)
"Although I appreciate that there will be changes, I don't think they will be as radical as is feared. The population is aging and the elderly, generally speaking, do not embrace technological advances immediately. From my own experience, patients even resent telephone consultations, as that is 'not like talking to the doctor – after all, how can a doctor diagnose me, without seeing me'. And during recent meetings it appears obvious that patients resent the idea of their local GP practice being closed in favour of polyclinics. Furthermore, I believe that there is a demand for seeing the same family doctor for continuity of care. I can, however, appreciate the benefits of additional resources such as polyclinics for more complex or very urgent cases" – Kirsten Hamilton, Lancs
"I think there will be a radical change. At the moment it feels as though the change will be for the worst but this is often the perspective of change. Different doesn't always mean worse though so perhaps we should use our expertise to ensure we get the best deal for all" – Sheila Gilbert, Sheffield
"I believe that primary care has been a monopoly and now we are being held accountable. This move will make primary care even more efficient and allow for future expansion to move towards one-stop shop for delivery of care. I believe that, although there are challenging times ahead, this is an
exciting time offering general practice vast opportunities. Private
companies need not be Virgin; they can also give GPs who are innovative and entrepreneurial a new way to expand their business" – Susan Reeves, Kent
"Excited, because it will improve working conditions for staff in GP practices, as more competition for their skills will drive GPs to recognise their worth" – Jolyon Vickers, Kent