At the Nuffield Health Policy Summit 2016, Martin Roland talks about what is needed to transform primary care.

1. #ntsummit
Transforming primary care
Professor Martin Roland CBE, Professor of Health Service
Research, University of Cambridge @ProfRoland

2. Re-engaging the workforce
to meet the challenges ahead:
Transforming primary care

3. The problems
• A rapidly ageing population
• Rising demand for care
• Increasing numbers of complex patients with multiple long-term
conditions
• Progressive move of care from hospitals to primary care
• Poor coordination between general practice, community health
services and hospitals, and between the NHS and social services
• Increasing problems in recruitment and retention for GPs, practice
nurses, community nurses

5. Practice
teams
MORE STAFF:
GPs, nurses,
pharmacists in
practices, HCAs,
physician
associates, admin
support
Federations etc
PRACTICE
SUPPORT:
Training
Governance
Local services
+ AS PROVIDERS
Integration
Specialists
Community nursing
Out of hours
Comm. pharmacy
BETTER I.T.:
Common records
email with specialists
email with patients

6. With its highly skilled workforce, effective multi-disciplinary teams and well-developed IT
systems, the NHS is in an unparalleled position to develop a modern primary care system
that is truly world class.”
“With its highly skilled workforce, effective multi-
disciplinary teams and well-developed IT systems,
the NHS is in an unparalleled position to develop a
modern primary care system that is truly world
class.”

8. Health Care Spending as a Percentage of
GDP 1985 to 2013
0
2
4
6
8
10
12
14
16
18
1985 1990 1995 2000 2005 2010
US (17.1%)
FR (11.6%)
SWE (11.5%)
GER (11.2%)
NETH (11.1%)
SWIZ (11.1%)
NZ (11.0%)
CAN (10.7%)
NOR (9.4%)
AUS (9.4%)*
UK (8.8%)
8
Notes: GDP refers to gross domestic product. Dutch and Swiss data current spending only
exclude spending on capital formation of health care providers. Source: OECD Health Data 2015.
Percent
*2012

9. 20 year relative disinvestment in general practice

10. % of NHS budget going to general practice
5
6
7
8
9
10
11
12
Column3
Column1
Column2

11. GP job stressors 1998-2015 (5 point scale, 1-5)
2.5
3
3.5
4
4.5
5
1998 2000 2002 2004 2006 2008 2010 2012 2014 2016
External requirements
Enough time to do job justice
Increasing workload
University of Manchester. 8th National GP Worklife Survey