A New Model for General Practice

A New Model for General Practice

Work Psychology Group, in collaboration with the Royal College of General Practitioners (RCGP), is pleased to announce the dissemination of the results from an extensive multi-source, multi-method job analysis study, which sought to gain deeper insight into the changing roles of General Practitioners in the UK.

A press release made this week by the RCGP summarised the rationale for the study and the implication of the findings, as such:

‘The traditional role of the GP is being challenged as the role has broadened from that centred on a ‘helping model’ in doctor-patient consultations to a role that also emphasises a ‘business model’ whereby GPs are increasingly required to consider how their work impacts local communities and wider health systems, reports this month’s British Journal of General Practice (BJGP).

Whilst good communication skills, empathy towards patients and professional integrity – along with clinical knowledge and expertise – will remain the most important attributes for a GP to have both now and in the future, they will need an additional set of skills if they are to meet the challenges of the NHS of the future and deliver on patient expectations.

The additional skill set – or “competencies” – will be necessary to cover the increasing need for GPs to work outside of their practices, embrace community involvement and take on tasks involving leadership and financial acumen, alongside their continued commitment to quality improvement in care.

Organisational, resource management skills and effective teamwork were also seen as important in the future of general practice. However, it was noted that these skills should be concentrated on during training, rather than at point of entry to a GP training scheme.

Overall, in the first job analysis study of its kind for 12 years, 11 competency domains were identified by Professor Fiona Patterson of Cambridge University and colleagues from the Work Psychology Group. It was found that whilst the skills and experience necessary to be a GP in the UK are still aligned with those in 2005, the domains have broadened considerably to include new responsibilities associated with balancing multiple agendas, including commissioning.

The study suggests that the challenge for GPs will be the ability to balance and maintain patient care and trust and professional integrity with resource management. It also warns against negative effects that this potential conflict might have on doctors and promotes the idea that high levels of self-efficacy will be a necessary trait for GPs of the future.

The study also questions whether current GP training will adequately prepare GPs to deal with increased psychosocial issues facing patients as well as non-clinical duties. The Royal College of General Practitioners (RCGP) has already had its educational case for extended and enhanced GP training accepted by Medical Education England. This will enhance GP training to four years with a special emphasis on GP placements in the areas of child health and mental health.

The multisource, multi-method study, involved over 1200 participants. It used a mix of stakeholder interviews, questionnaires and an expert panel review to assess the skills and competencies a GP should be able to demonstrate now, in the future and at point of training. The stakeholders interviewed included representatives of COGPED and the British International Doctors Association (BIDA) as well as patient groups and trainee GPs.

RCGP Honorary Secretary and workforce lead Professor Amanda Howe said: “This is a far reaching study with far-reaching implications for the future of the profession. It reinforces everything that the RCGP has been saying through our work on the Commission on Generalism and other initiatives.

“Many of our members working in general practice today are already demonstrating the broader breadth of skills outlined in the study, particularly with the introduction of the new commissioning agenda.

“But we must acknowledge that most GPs entered general practice to care for patients. This vital relationship is the cornerstone of the NHS and it must not be lost or downgraded as we take on additional roles and responsibilities.”

Professor Fiona Patterson, the lead author of the report said: “Our study provides evidence that there is now a pressing need to determine how the greater breadth of capabilities required can be addressed during education and training to support and equip GPs in the future”.’