Dr David Mummery takes a look at what 2023 could have in store
This year is likely to be pivotal in the history of general practice. Will it remain as the greatest medical profession? Or under the current government, will it disintegrate into a tangled mess of digital confusion, AI chatbots and unspecified additional roles? Here are my speculations.
January: Matt Hancock celebrates his new TV talk show, The Matt Hancock Show; the NHS experiences its busiest winter on record and primary care teams are barraged with online consultations; average daily patient contacts per GP exceed 90.
February: Brexit stagflation and medication shortages are worsening, with Sertraline, Flucloxacillin and Insulin pens in short supply; service charges for practices have quintupled over the past 12 months due to soaring energy prices, so practices can no longer afford heating; NHSE launches a ‘Heat Your Surgeries’ campaign, encouraging patients to bring battery-operated heaters and blankets to help GPs stay warm.
March: The Matt Hancock Show is a big hit, averaging 21 million viewers per episode.
April: BMA GPC UK submits mass resignations, leaving no representative GP committee at the BMA; grassroots GPs notice little difference.
May: The first of the new Integrated Care Assessment Centres, AKA Fuller Centres, open in the UK, with 30 more planned in the next 18 months; the new Integrated Neighbourhood Teams relocate to repurposed office blocks, including 40% of the GP workforce; each integrated care worker (this is what NHSE calls all Fuller Centre workers) is allocated a small booth, computer and headset.
NHSE/BMA guidance says the term ‘patient’ is offensive; ‘client’ and ‘service user’ must be used.
June: More than 100 GP partners stage a 48-hour sit-down protest in Whitehall, but the police intervene and drag them away in front of a crowd of reporters; The Daily Mail splashes ‘Serves them right: justice at last’ on its front page.
July: Last month, 56 GP surgeries shut; the number of GP partners is in freefall; Steve Barclay says the ‘transformation into community and neighbourhood teams’ is a huge success and nearing completion; NHSE brings in an integrated care performance tracking system at Fuller Centres to monitor each integrated care worker’s hours and consultation rates.
August: Jeremy Hunt says he is ‘very sad’ and ‘deeply regrets’ that general practice has got itself into such a mess. He says he aims for ‘zero-tolerance’ of bad GP performance and a health system with ‘Swiss efficiency’ and ‘Chinese managerial style’. When asked about his time as health secretary, he says he is ‘very regretful’ that doctors did not take his advice.
September: New US healthcare provider TrumpMed Inc. takes over the private GP practice where Prime Minister Rishi Sunak is registered.
October: The BMA consultants committee votes for all tests and follow-ups to be done in the community, as GPs ‘are the most appropriate people to do it’.
November: NHSE says the term ‘general practitioner’ is outdated and should no longer be used.
December: Eighty percent of GPs have been reassigned to Fuller Centres; the GP partnership model has collapsed, so integrated care workers and any remaining GPs are employed by call centre owners.
Matt Hancock announces he has changed his mind about leaving politics; due to ‘overwhelming public support’, he will now stand for the Tory leadership.
Dr David Mummery is a GP in west London. A shorter version of his article appeared in the January 2023 issue of Pulse
