Book Review: The future of general practice

Mark Newbold reviews “The future of general practice: Real life case studies of innovation and new ways of working” by Ben Gowland and Ian Keeber of Ockham Healthcare.

Ockham Healthcare describe themselves as a ‘think tank and consultancy’. Ben Gowland has a background in general practice and commissioning in Northants, and is now setting out to ‘support innovation in general practice’ through his new venture

This book starts by asking the question ‘What is really going on in general practice?’ It then proceeds to answer it by presenting a comprehensive range of case studies from around the country.

Whilst fully acknowledging the challenging reality of modern general practice, it is undoubtedly an optimistic book that demonstrates just how much is being achieved to meet the challenges and move general practice into a better place.

The first section tackles the issue of ‘new roles’ through five case studies in which the contributions of paramedic practitioners, pharmacists and pharmacy partners, ANPs, extended role physiotherapists and others are detailed. Each study describes the ‘problem to be solved’ and then outlines practical steps, benefits and lessons learned. Brilliant as a resource to dip into for ideas and guidance. The case studies are followed by analysis from the authors, neatly organised into ’10 practical steps for GP practices’ and then ‘3 Top Tips to support the recruitment of GPs’. The latter section is helpful, though very brief – my guess is that this could usefully be a major article by itself?

‘Operating at scale’ is covered in Section Two. The Case Studies include my own, Our Health Partnership in Birmingham, along with the St Austell Healthcare Group in Cornwall and the Portsdown Group in Portsmouth. Again, concise and easy to read, with practical aspects and lessons learned clearly highlighted, and followed by an analysis by the authors. The analysis is authorative and helpful, organised into ’12 benefits of working at scale’, and then ’10 practical steps for GP practices’. Finally there is a short piece on the challenges facing GP Federations that describes how the opportunities and challenges for federations have changed over the last few years as the wider NHS landscape has shifted from competition to integration as a broad approach

Section Three covers New Models of Care. It is again based on (five) Case Studies from Hampshire, Somerset, Notts., South Devon and Gateshead. Plenty of information and practical guidance, and followed by analysis that pulls together how different ways of working can help practices. I particularly like the ‘Tips on creating partnerships’ – definitely a key theme of todays NHS and dealt with in a pragmatic and real world way.

The final section deals with CCGs and general practice. It looks at the transformation journey in Tower Hamlets, an innovative new contract in Bolton, and then addresses in some detail the establishment of local locum GP chambers. I found the latter piece particularly interesting as the wish of younger GPs in particular to work differently, and choosing to achieve this via the locum route, is something we are hearing consistently at GP View. (Also explored in a latest anonymous view)

Overall, this is probably the best summary of the options open to general practice that I have seen. It is just over 100 pages, laid out concisely, and packed with examples, tips, lessons and practical guidance. Inevitably it will date as the process of change in the NHS continues apace, but for now I heartily recommend it to everyone interested in the options for GP development.

To order the book, which is £24.99, click here

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