It’s frightening how much can change in three months. When we carried out the survey for the Primary Concerns report in December last year, the biggest story facing primary care was how it was delivering more joined-up care to patients across the NHS and boosting the resilience of general practice. In England, the biggest concern for all those who work in general practice was the delivery of primary care networks and the demands on already tight resources, as well as the uncertainty of how this new model of care would take shape.
Now as I write, all this has taken a back seat. We are now in the midst of the biggest pandemic to hit the modern world. Covid-19 has really taken hold and our audience is at the forefront of the battle. The rest of the nation is being asked to stay in the safety of their homes but those working in the NHS, including those in primary care, don’t have that option. From the decision makers – GP partners, practice managers and pharmacy contractors superintendent pharmacists – to salaried and locum GPs, practice nurses, pharmacy employees and healthcare assistants who work on the ground, as well as district and community nurses, all now have a vital role to play in the fight against the new virus.
The situation is developing by the day as the number of patients affected by the virus increases – and primary care is having to adapt at pace. From what I hear, many of our readers in general practice are getting used to doing most of their consultations remotely and to add to the strain, GPs fear they may suddenly be inundated with prematurely discharged hospital patients whom secondary care has been forced to send their way as it clears beds for those hit by the virus.
All this does not mean that the way our audiences felt three months ago, and probably would be feeling now if Covid-19 had not hit, is no longer relevant. In fact, as primary care faces up to what is its biggest test to date, the coming months are likely to tell us how far the concerning issues highlighted throughout our report are going to affect its ability to respond to this national crisis.
Once again, our Primary Concerns survey has been able to capture the opinions of those who know the sector the best. And for the 2019 survey, our seventh to date, we continue to focus on the real issues that concern our readers. The wide reach of our five publications means we can capture the opinions of a range of healthcare professionals, to gather first-hand evidence of how they are coping with ever-increasing patient demand against a backdrop of dwindling GP numbers, fewer nurses and rising workloads.
We have been able to assess the state of the relationship between GPs and pharmacists, and we’ve looked again at how GPs’ and nurses’ prescribing habits have changed in the past 12 months. We also asked about the specific cutbacks and concessions made or considered during 2019, and whether full-blown closures were on the cards. And for what could be the starkest indication of a sector in despair, we can reveal how big a proportion of respondents are considering quitting primary care altogether.
The evidence we have gathered about the current state of primary care will be reflected in how well it grapples with the coronavirus crisis and how the wider NHS copes when it is needed most. Never before has there been such an appreciation of the work our NHS staff carry out, and I for one will continue to applaud and thank them for all they are giving us in this time of need.
However, we must seek opportunities in this crisis. We must use this platform to underline the need for real change, and finally resolve the issues unearthed in our report. Yes, we need our politicians’ help, but we also need leadership from within our sector to shout about the problems they are facing. Through our publications we can also help by being the voice that continues to hold the Government to account.
Unarguably, when this is all over, ministers will need to reassess the entire NHS and that should start right at the front door, with primary care.