Dr. Maureen Baker is the chair of the Royal College of General Practitioners. She discusses the crisis facing general practice due to lack of funding and resources. Patient care is suffering as GP practices do not have enough staff or funding to cope with increasing demand. Dr. Baker campaigned vigorously to raise awareness of the problems in general practice. While promises have been made to increase funding, only time will tell if they are fulfilled after the upcoming general election. Federations of GP practices working together may be part of the solution by increasing services while managing resources efficiently. Enabling patients to better manage their own care could also help alleviate pressures on the health system.

1. Management
Page 25
You have been described as an energetic
leader. Is this essential in raising public
awareness of what GPs face every day?
I am proud to represent more than 50,000
GPs and to play my part in campaigning to
put general practice on a stable, sustainable
footing so we can continue to provide excellent
care for all our patients for years to come.
Being energetic helps me get the message out
to as many people as possible, but honesty and
determination are most important. The problems
generated for our patients by the pressures
facing general practice have reached crisis
levels and I have not minced by words in stating
this. Some people were shocked when I said that
general practice (as we know it) is on the verge
of extinction, but it is true and it is something that
needed to be said. The determination is paying
off now because people in NHS England and in
the corridors of power are starting to listen.
Why the need for the campaign, ‘Put Patients
First: Back general practice’?
We launched the campaign in November 2013
because general practice was in a terrible state
and nobody was talking about it. NHS funding for
general practice has fallen from 10.5% in 2010 to
8.3% and GPs and their teams, who make 90%
of NHS patient contacts – and our patients –
are bearing the brunt. With our growing and
ageing population, and an increasing number
of patients with complex needs, GP surgeries
simply do not have enough resources to cope
with these twin pressures. GPs are making
1.3 million patient consultations every day –
150,000 more than even five years ago. The
College’s campaign has put these issues on the
political agenda and – although we still have
a long way to go – we are making progress in
achieving our goal of a shift in NHS resources
into general practice. In England, we are now
moving into the second phase of the campaign
to try to recruit, retain and ‘return’ – make it
easier for trained GPs who have taken a career
break to return to practice – so we can have
10,000 more GPs across the UK by 2020.
We also need significantly more practice staff
members.
We caught up with the country’s most influential GP ahead
of next month’s General Election…
Page 24 April 2015 ︲ www.practice-management.org.uk
Investment in primary care is low compared
to other sectors of the NHS. Is education
of patients and their health a key player
in halting the need for more money in
secondary care? Where should this start?
Investing in primary care is key to alleviating
pressures right across the health service.
Patients can play their part in keeping the
health service sustainable, too. Patients who
understand and are involved in their own health
and needs are more in control of their lives
– and this is good for everyone. As demand
increases, self care is going to play a bigger role
in the future health service. This is something
that has been highlighted by both the College’s
The 2022 GP vision for the future of general
practice and the recent independent Inquiry into
Patient Centred Care in the 21st Century report,
commissioned by the College last year.
It’s about our patients having more
understanding about the benefits of a healthy
lifestyle – and also when they need to see a
doctor, or whether they can get the treatment
they need from a pharmacist, or even help
themselves. Enabling patients to take better care
of their health must start in GP surgeries. GPs
Dr Maureen Baker is a
general practitioner and
is the current chair of the
Royal College of General
Practitioners. She took up
this position in November
2013. She was honorary
secretary from 1999-2009.
Dr Maureen Baker
An appointment with
have a unique relationship with their patients,
built over time, and so are ideally placed to
provide help and advice to patients about how to
take control of their own health but this will only
be possible alongside wider societal shifts in
attitudes.
With a General Election imminent, how
hopeful are you for change – and for further
investment in healthcare? What promises
do you wish to see – and see fulfilled – 12
months from now?
There has been recognition in all four UK nations
of the pressures facing general practice – and
promising pledges to address them. In England,
with the General Election in May, politicians from
all major parties have acknowledged the lack of
investment in general practice and the chronic
shortage of GPs and practice staff and have also
committed to providing extra resources, including
more GPs.
This has been backed up by NHS England’s
Five Year Forward View, that talks about ‘a new
deal for general practice’, making the case for
a shift in resources into general practice and
for GPs to play a leading role as gatekeepers
managing patient referrals to the rest of the
system. Of course, it is easy to make promises
– especially in the run up to an election – but
it is essential that whichever government does
come to power it delivers on its promises and
works with NHS England to implement the
recommendations in the FYFV. Put patients first:
Back general practice is a UK-wide campaign
and, although the degree of headway varies
from country to country, there have been
promising moves towards more appropriate
funding for general practice in Scotland and
Wales – and we are working hard to secure this,
as well promoting the case for drastic change in
Northern Ireland.
Are federations the future of primary care?
I was involved when the College first pioneered
GP federations nearly 10 years ago and, to me,
they remain the most sensible way forward. It
is clear that, as well as securing more funding,
we will also need to think about new ways of
working and the introduction of new models of
care. Better integration of primary, secondary
and community services is something that the
College supports – and has been backed by the
independent Inquiry into Patient Centred Care.
This can be made possible through federations
– groups of individual GP practices work in
partnership with each other to share expertise
and pool resources in the best interests of
patients. Patients are becoming more complex
and federations offer the availability of increased
and more specialist services, increasing
continuity. We are open to other new models
of care, such as the Multi-specialty Community
Provider model championed in NHS England’s
FYFV, but it is important decisions are based in
the best interests of patients in a local area.
How do you think most patients feel about
their GP practice? Are they delivering what
patients need?
Despite the pressures on GP surgeries, it is
testament to the hard work and dedication of
GPs across the country that over 90% patients
say they have trust in their GP, according to
the latest GP patient survey. We know we must
never be complacent in delivering the care we
provide to patients and GPs and their teams
want to offer more, better, and more flexible
services. We will keep on putting pressure on
governments across the UK to act, but now all
we can do is wait to see if promises that have
been made are delivered.
New horizons
 We need significantly more GPs and
practice staff members
 We need to try to recruit, retain and
‘return’ GPs, making it easier for them to
return after a career break
 Self care is going to play a bigger role in
the future health service
 Enabling patients to take better care of
themselves must happen in the community
and it must start in GP surgeries
 GPs to play a leading role as gatekeepers
managing patient referrals to the rest of the
system
All about you
Practice managers play an essential role in general practice
– and the wider health service – and I’m incredibly grateful to
all of them for the support they provide to GPs right across the
country
We heard earlier this month that NHS England has pledged
£1 billion to be invested in practice premises over the next four
years, so practice managers will have a key role in ensuring
the money is spent in the best interests of their patients.
This is really good news for practices, our patients and the
wider NHS as the funding will not only to improve premises,
but can be used to invest in technology and give practices the
capacity to offer more appointments, and alleviate pressure
across the health service
Practice managers know their local population – this
knowledge and support will be essential in allocating
resources to ensure patient-centred goals are achieved
The success of federations will depend on them meeting the
needs of a local population and it is practice managers who
understand these most
Far from practice managers having a diminishing role as
federations rollout, their expertise will make them central
to delivering the best possible services to patients with the
resources available to them
And finally…
Practice managers are essential within the practice team
and this isn’t going to change
‘The problems
generated for
our patients by
the pressures
facing general
practice have
reached crisis
levels and I have
not minced by
words in stating
this’