YSHA meeting 11th May 2019
at Mill Hill Chapel, Leeds
Jack: General practice cannot to be just a set of tasks carried out in relentlessly driven isolation. It must return to its role as family practice, committed to understanding local communities and the families that live in them, and supporting them in pursuing their own health
John: Primary Care Networks (PCNs) and a Charter for Primary Care
Summary of the practical issues raised:
- GPs are no longer family doctors, so we miss the notion of community. We need get back to Primary Care Teams. However, we are so used to being in a command and control environment that many GPs will not have the skills needed for a participatory culture. They will need to be helped to design a management system conducive to collaboration and to develop engagement policies and skills.
- PCNs are an overkill. Structural changes, e.g. compartmentalisation of function and role are not conducive to collaboration. It is not something you can “harness” – a classic top down policy that politicians use to disguise their control pathology. We need to provide a collaborative model that that really works, as opposed to strangling people’s efforts to cooperate.
- The vision needs to include real shared values embedded in policies, e.g. we will really understand the patients’ needs before applying a solution and will engage the patient and their family/community in the process. Then like the GPs we may need to train the staff in these engagement skills, using a set of behavioural skills that have been shown empirically to work. The vision may also wish to include a profit-sharing policy without profiteering, e.g. ask staff how any surplus could be distributed – externally as well as internally.
- Only then look at the legal structure the PCN might need, e.g. a Community Interest Company (CIC).
The meeting had a very engaging and informed discussion on economics and, in particular, Modern Monetary Theory, which could dramatically change the SHA and politicians’ stance on funding.