GP Services

Roger Williams Excerpts

Thursday 5th February 2015 Commons Chamber

[Sarah Newton]

That is a good point. We have to look at how general practices are set up these days. Not all general practitioners want to be part of the old partnership model, which is a sort of small business. Many now would like to be salaried and work particular hours in particular settings. I would not want to prescribe a particular model: we need to look flexibly at different models of provision that meet patients’ needs, taking into consideration what the work force need to enable them to play their full part.

GP practices in my area are expanding the range of services that they are able to provide to the community. As hon. Members will know, I represent a large, remote, sparsely populated part of the country, and such expansion is especially important for rural areas. One example is the Probus surgery of GPs, which serves many villages in its rural community. It is expanding into many areas, including minor surgery. I have yet to come across anyone who has anything other than praise for the Probus surgery, which provides the normal services one would expect from a surgery, but also works closely with its primary care partners and district nurses. It also links up with care managers for people with chronic conditions and elderly people living at home.

By comparison, a very different group of GPs work at Penryn surgery. They serve a large campus that is home to Exeter university, Falmouth university and parts of Plymouth university. There is a growing student population and the surgery has been able to expand its services to provide mental health services, prescribing services and on-campus surgeries. In attracting additional funding for services to meet the needs of the young people—we welcome them into the constituency to study there—they have additional resources from which the whole community can benefit.

Those are two very different examples of how GPs are working positively and constructively with local commissioners to expand services, bring in additional resources and improve patient outcomes for the local community.

[Roger Williams (Brecon and Radnorshire) (LD)]

My hon. Friend represents a very rural constituency, as I do. We do not have any single GP practices, but many of our practices have fewer than five GPs. Our experience is that when one leaves and the practice has difficulty recruiting, it really puts the practice under pressure. Can anything be done to make rural GP practice more attractive to young doctors?

[Sarah Newton]

That is a very good point, and I was just about to make the point that although I have given two good examples of larger GP practices that are doing very well, I also have similar issues to my hon. Friend in more sparsely populated areas of my constituency, such as the Roseland peninsula. It has an older population and it is difficult for GP practices to innovate and bring in additional services to make their future sustainable. I am in regular correspondence with NHS England, which has taken away some of the specific funding that used to be available to support remote rural GPs, in the expectation that they will be able to attract additional funding for providing additional services. That is really not possible or viable. In order to maintain access for people living in sparsely populated areas, where the population is unlikely to grow rapidly, NHS England needs to look again at funding for GP practices in such areas. I hope that my hon. Friend will make common cause with me in writing to NHS England to ask it to reconsider that point as part of its five-year plan.

The third point I wish to make is the positive work I see at the accident and emergency department at Treliske. The Royal Cornwall hospital is the only acute hospital in Cornwall and I am proud to have it in my constituency. The head of the A and E department at Treliske has worked innovatively with his primary care partners to introduce GPs into that setting. As people arrive at the hospital, a triage system is in place so that if people would be better served by seeing a GP, they can do so, which takes pressure off the A and E department.

Finally, I wish to share some of the learning from the integration pioneer work that is happening in Cornwall. The Government designated 14 areas of the country as pioneer areas to look at how we can better integrate care services with the NHS. GPs in Cornwall have provided an essential foundation for that work. Our pioneer bid is led by Volunteer Cornwall and Age UK Cornwall—I think it is the only voluntary sector pioneer bid in the country, and it is very much supported by the NHS right across Cornwall, and by Cornwall council.

By working carefully with GPs to identify frail, elderly and vulnerable groups of people with chronic conditions who tend to use the NHS a great deal—GP services, care services or the acute sector—the pioneer discovered that having a trained volunteer attached to a GP surgery to work alongside families, linking up all available support and enabling them to reintegrate into the community around them, leads to a huge reduction in the use of acute and GP services, and, most importantly, significant increases in self-reported well-being.

There are a lot of lessons that can be learnt from the reforms we have put in place. I am confident that if NHS England’s five-year programme learns the lessons from the pilots and the past five years and puts proper resources into primary care, we can see the improved health outcomes I know we all want.