Author: Sarah Armes
Editor: Sarah Anderson
This blog is the second in a three-part series covering key insights from the 2024 Modality Pathfinder Lifestyles Summit.
The healthcare system stands at a pivotal moment, with mounting demands on general
practice far outstripping capacity. Addressing this crisis requires a fundamental shift from the traditional medical model to a more holistic social model.
This approach integrates lifestyle medicine, social prescribing, and multidisciplinary collaboration, placing communities and individuals at the heart of care.
The Value of Continuity in Care
Continuity of care is fundamental to effective general practice. Research highlights its benefits, including:
Better patient satisfaction and trust.
Lower emergency department attendance and hospital admissions.
Reduced mortality rates.
Improved adherence to medical advice and preventative measures.
Continuity strengthens the doctor-patient relationship, allowing for personalised, community-focused care. Yet, the reality often diverges from this vision. A 2024 King's Fund report points to the misalignment of financial and workforce growth with the ideal of community-centred health services.
Where Are We Now?
The challenges facing general practice are daunting:
An ageing population, combined with increasing chronic disease rates, is driven not only by age but also by lifestyle factors such as obesity and poor health literacy.
Social inequalities exacerbate health disparities, with deprived areas facing higher patient loads and lower GP earnings.
An overstretched workforce, with 550 fewer GPs since 2019 and 42% of current GPs planning to leave the profession within five years.
Despite these pressures, advancements in medical technology, AI, and treatments promise new ways to manage illnesses. However, the system must be structured to harness these innovations effectively.
The Role of Communities in Health
Communities play a vital role in public health, particularly in reducing health inequalities. A social model of care empowers individuals to take charge of their health, moving away from a top-down approach where patients are passive recipients. Instead, care becomes a shared responsibility across society, fostering connected, resilient communities.
This shift also requires recognising the broader determinants of health. Only 17% of healthcare presentations are rooted in biomedical causes, while social and economic factors drive the rest. We can create a more equitable and effective system by addressing these upstream issues.
The Pressure on GPs
General practice is under severe strain:
There are now 2,300 patients per full-time equivalent GP, compared to 1,800 in 1988.
GPs in deprived areas manage 11% more patients yet earn 7% less per patient.
Stress and burnout are rampant, with 71% of UK GPs describing their work as extremely stressful and unsustainable.
Despite these challenges, UK GPs excel in managing complex care and holistic approaches that address patients' social and economic needs.
Envisioning the Future
What should the future of general practice look like?
Family and Community-Centred Care: Keeping patients close to home with integrated support networks.
Emphasis on Prevention: Shifting focus to early detection and preventative health measures.
Continuity of Care: Strengthening long-term doctor-patient relationships.
Multidisciplinary Teams: Collaborating with social care, speciality teams, and community organisations.
Equitable Access: Ensuring fair distribution of services across all regions.
Adequate Workforce: Increasing GP numbers to alleviate pressure and allow time for meaningful patient interactions.
Turning Challenges into Opportunities
Addressing these systemic issues requires bold, long-term solutions. This includes:
Ending GP-Bashing: Valuing healthcare workers and trusting clinicians to deliver patient-centred care.
Strategic Planning: Moving beyond short-term fixes to comprehensive reforms inspired by the vision of NHS founders.
Harnessing Technology: Utilising digital tools to complement rather than replace the human connection in healthcare.
Investing in Prevention: Aligning funding priorities with the goal of reducing future demand through better health outcomes today.
A Way Forward
The future of general practice hinges on reimagining care as a partnership between individuals, communities, and healthcare providers. By addressing the systemic barriers that hinder progress, the healthcare system can evolve to meet the needs of an ageing population, rising chronic disease prevalence, and shifting patient expectations.
The path forward requires innovation, collaboration, and a commitment to the values that have long defined general practice—family medicine, continuity of care, and a deep connection to the communities it serves.
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