NHS Must Recognise and Enhance the Role of Generalists

The important job of a ‘medical generalist’, or ‘expert in whole-person medicine’, needs to be more commonly acknowledged and improved if the NHS are to meet the challenges facing them, a new report published by the RCGP stresses.

The importance and influence of medical generalists should be given fresh attention within a much broader background than general practice and primary care, according to the study, which is the Royal College of General Practitioners (RCGP)’s formal response to the conclusions of the Independent Commission on Generalism, which reported about the issue last October.

The Commission’s report had discovered that, generally, generalists and GPs are so vital in the NHS that “if they did not currently exist, they would have to be invented,” the Royal College noted.

Although, the Commission also determined that, while medical generalism is the foundation of the UK healthcare system through general practice, it continues to be poorly-recognised, but it has a solid and increasing role to play in how healthcare must adapt to respond to a growing elderly population with numerous chronic conditions.

Medical generalists offer healthcare that is concentrated on the patient’s wellbeing, whilst providing broader benefits, helping guarantee that the NHS continues to be one of the most economical health organisations globally, commented the RCGP.

Doctors also need to be provided greater support to protect and improve their role, including lengthier training, and they require additional time with patients, improved access to diagnostics and better communication with experts, the response from the Royal College of General Practitioners stated.

The Royal College of General Practitioners outlined 10 different priority areas that aim to evaluate the disciplines of GPs and other medical generalists from alternative viewpoints and guarantee that they are equipped to meet the evolving requirements of their patients.

These areas are the:

•    Effective use of patient feedback
•    Development of generalist models of care for complex and chronic conditions in the community
•    Policy on out-of-hours care
•    Extended training for GPs
•    Enhanced training in paediatric care, learning disabilities, mental health, palliative and end of life care
•    Improved communication between GPs and specialists
•    Nursing home care
•    Use of IT, data sharing and inter-agency e-communications
•    Further research into multiple morbidities and early, accurate diagnosis in primary care
•    GP-led commissioning.

Professor Amanda Howe, RCGP’s honorary secretary, who is leading the work, commented that “generalists are professionals who are committed to the patient as a person.”  “They retain responsibility for patients over time, deal with many issues and help patients to make judgements that are safe for them and the system.”

“Whether a practitioner is a true generalist or not depends on their training, their attitudes, their scope of practice and frequently their work setting. There is a difference between a generalist and using generalist skills,” she noted.

“The GP remains the front door and the community interface of the NHS, and principles of practice are still based on two key concepts – holistic and patient-centred care. Our report shows that GPs are very positive about seeing the basis of our discipline from a new perspective and are keen to have the value and skills of medical generalists more strongly supported across the modern NHS,” Howe added.

Adrian Sieff, assistant director at the Health Foundation – which, with the RCGP, founded the Independent Commission on Generalism – applauded GPs’ continuing commitment to patients as a entire person.  “Seeing the person in the patient and understanding the needs, wishes and priorities of each individual is vital to improving the quality of healthcare,” Sieff noted.


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