View of the strengths of primary care, ways to release more of their potential and the contribution of the General Practice Forward View. At county-wide primary care, Worcestershire.

1. #GPforwardview#GPforwardview
Dr Robert Varnam
Head of General Practice Development
NHS England
@robertvarnam
england.nhs.uk/gpfv

2. www.england.nhs.uk @robertvarnam
UK general practice is one of the world’s most comprehensive embodiments of the
founding principles of primary care…
Personal care built on a
relationship from cradle to grave
Community based responsible for
prevention and care of a registered population
Holistic perspective understanding
the whole patient not just a disease
Comprehensive skills to
diagnose & manage almost anything
Personal and population-orientated primary care is central …
if general practice fails, the whole NHS fails. Simon Stevens, General Practice Forward View

3. #GPforwardview
Pressures on general practice
↑ population
↑ consultations
↑ complexity
↑ costs
↓ relative funding
↓ relative workforce

4. www.england.nhs.uk @robertvarnam
Specialists
Non-specialist / failed consultant
Gatekeeper / door-holder
King of my castle
It’s all in me
Community
services

5. www.england.nhs.uk @robertvarnam
Community
services
Specialists
Non-specialist / failed consultant
Gatekeeper / door-holder
King of my castle
It’s all in me
Excellent continuity (by default)
The GP is there for everything
Complex care often disjointed
GPs professionally isolated and undervalued
The GP is there for everything
Biopsychosocial needs often met in medical way
Overdiagnosis & overtreatment
GPs & patients have been imprisoned within
the walls of a castle that is too small.

6. www.england.nhs.uk @robertvarnam
Self
Care
Broader skillmix
Self
management /
social
prescribing
Emergency
care
Collaboration
with specialists
At scale
Population wellbeing management
and holistic person-centred care
provided by a multiprofessional team
led by the GP, supported by at-scale
collaboration and efficiencies.

7. www.england.nhs.uk @robertvarnam
Self
Care
111 Online
and 111 Hubs
nhs.uk
Community
pharmacy
Advanced Nurse
Practitioner
Physician
Associate
Physiotherapist
Clinical
Pharmacist
Minor ailment
service
Mental Health
Therapist
Broader skillmix
Patient
Activation
Apps and
wearables
Self
management /
social
prescribing
Community
based care
and support
Peer support
Welfare
advice
Health
coaching
Emergency
care
Collaboration
with specialists
Specialist
support
Enhanced
Advice and
Guidance
At scale
Specialist
services
Community
services
Access
hub
Holistic person-centred care
provided by a
multiprofessional team led by
the GP, supported by at-scale
collaboration and efficiencies.

8. www.england.nhs.uk @robertvarnam
Knowledge, skills,
confidence and support
More care close
to home
Empowered to play a greater
role in staying well and caring
for themselves, with access to
comprehensive responsive care
close to home.
Flexible access to the
right person at the
right time

9. #GPforwardview
The
problems

10. #GPforwardview
www.england.nhs.uk/gpfv

11. www.england.nhs.uk @robertvarnam
Self
Care
Broader skillmix
Self
management /
social
prescribing
Emergency
care
Collaboration
with specialists
At scale
Population wellbeing management
and holistic person-centred care
provided by a multiprofessional team
led by the GP, supported by at-scale
collaboration and efficiencies.
What are
our priorities?

12. #GPforwardview
www.england.nhs.uk/gpfv
england.nhs.uk/ourwork/gpfv/gp-indemnity/
england.nhs.uk/ourwork/gpfv/resilience/
bit.ly/MCPframe1