Why now is the time for a career in general practice

The health service will need the skills of the expert medical generalist to meet the challenge presented by chronic conditions and multi-morbidities. Our population is getting older and it is growing in size. As people live longer, more and more are managing multiple, long-term conditions – so both the amount of healthcare needed and its complexity is rapidly increasing. Because of this dramatic increase in multi-morbidity, the way we think about health is changing. For many patients it is no longer enough to treat a single ‘one off’ aliment, we must consider how patients can adapt and learn to live with chronic long-term diseases. That is why the clinical role of the GP as an expert medical generalist with the breadth of medical knowledge to understand complex, multiple, long-term conditions is now so central to the care we provide in the NHS

In order to meet the challenges of modern healthcare, the NHS is changing throughout the UK. More care is going to be provided by GPs and their teams, instead of by hospitals. As patients increasingly manage long-term conditions and multimorbidities, it is no longer possible or desirable for the majority of care to be provided in hospitals. Instead care must move into communities and therefore to general practice.

So the way GPs work is evolving, with GPs taking on new and exciting roles both clinically and as leaders designing and managing services for patients.

The new roles a GP will take on in the future mean that a career in general practice will be flexible, diverse and challenging. GPs will have the opportunity to build a varied portfolio career, in a range of settings, as well as having the chance to work part-time at different stages throughout their working life.

GPs will be able to move between many different roles and locations throughout their careers, and they will have the opportunity to build flexible working patterns around the needs of their patients as well as their personal lives. Exciting new ways of working in general practice are evolving in our changing health service in addition to the huge breadth of different roles that have always been available to family doctors.

As more care moves from hospitals and into the community, the way general practice is organised is evolving and scaling up to meet demand.

Instead of working in small single practices, GPs will increasingly work as part of groups of practices. Sometimes this will mean an informal ‘network’ arrangement between practices, where there is no legal or contractual connection. But it can also mean shared responsibility as a ‘federation’ with a legal agreement to work together to provide a wide range of services. It can even mean a formal merger between practices as a ‘super partnership’ to form a single contract between them. With these new ways of organising general practice will come more investment in high quality facilities for providing modern healthcare.

GPs will not face the challenges of modern healthcare alone. In future they will work increasingly at the head of ‘multi-disciplinary’ general practice teams.

Patients with long-term needs and multi-morbidities will need a network of professionals around them to help organise and plan their ongoing care. So a wider range of professionals will support GPs to provide care that is truly designed around the patients’ needs. Increasingly, when a GP sees a patient they will have already gone though preparation and discussion with other professionals. That might mean talking to clerical staff about their documentation, or to a pharmacist based in the practice about the medication they are taking. So when the GP sees their patient, time is freed up for the GP to use his or her expert generalist skills to undertake a full holistic clinical assessment to inform their ongoing care plan.

Part of this care plan might be to draw on further support from professionals in the wider general practice team. For example, the GP might identify a potential mental health issue, so arrange for the patient to see a mental health therapist based in the practice. Or the patient may need rehabilitation after a stroke or heart attack and be referred to a practice-based physiotherapist.

The GP will also be able to draw on practice and community nurses to help administer treatments either in the practice or in a patient’s home. The GP may also be able to call on people in new roles, such as medical assistants, who could perform routine administrative or clinical tasks such as form filling or checking blood pressures, again freeing up time for the GP to concentrate on the most complex tasks and cases.