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Secret Diary of a PM - Looking Forward to 2020

At the start of a New Year and a new decade, an anonymous PM reflects on the changes we have seen in primary care and the wider NHS in the 2010s and asks what the future has in store for our National Health Service.

Over the past 10 years we have seen advancements in medical science that enable people to live much longer, but this obviously means we need more staff and resources. Such treatments are also often costly and, having faced years of austerity, this has put immense pressure on the NHS.

Running Faster Just to Keep Still

Overall, 2019 seemed to bring little change in direction for the NHS, but in the run-up to the December election we were made many promises about how things would improve in the coming years from all parties. 

From recruiting more nurses and doctors to increasing the number of appointments available by 50million a year, it would seem on the face of it that many of our problems are being tackled head-on.

Sadly I fear that is not really the case, as it takes years to train new staff. Unless drastic changes are made to the current working conditions, we will continue to see many staff leave the NHS due to constant stresses on the work force.  

Now that we are leaving the EU, many members of the workforce from EU countries are returning home, as England is not the same any more in their eyes and they question how welcome they are to stay here.

All of this means we will continue needing to run faster just to keep still. Whilst funding is being increased, it is never enough.

Is Privatisation the Future of the NHS?

The question of whether the NHS is going to become increasingly privatised over the next few years is a constant worry and it has been for a while now. Despite repeated denials, we cannot be certain it will never happen. If it does, only the parts that are profitable are likely to be cherry picked, leaving the rest at the will off the government.

I know that the government has said under no circumstances will they let the NHS be privatised, but they have shorter memories than us, and just may be tempted to put various parts on the table.

I do worry about the future, as it is unsustainable at the present level unless changes and expectations are managed. There needs to be more discussions about what is expected of patients, and how they can help the NHS survive.

I fear that the next couple of years will be more of the same, with ever-increasing pressure swallowing up the limited resources we have. We need to look at our social care and mental health problems which have increased over the 10 years and now affect many more people, and work out how we can address these issues.

The Future of Primary Care Networks

This year will see the continuation of Primary Care Networks and I genuinely feel there are positive aspects to them. On the other hand we seem to have been left in the dark to some extent about what exactly is going to be required of us in 2020/21 and beyond.

This article bears resemblance to others I have written, where I argued the NHS should be taken out of politics and a cross-party commission set up to make the most of the skills of people already heavily involved in the health service.

I just do not believe that Civil Servants and MPs have a firm grasp on how the NHS works, as if they did they would be making other decisions on the running of the NHS. Unless some of the big issues are properly addressed, there is a limit as to how much more we in Primary Care can take on.

It is unfair that the media and MPs seem to blame all the problems on clinicians and staff, failing to express the truth of issues. For example, the recent publicity on home visits, when doctors voted to stop doing them was reported in a one-sided way.

The press did not report that the idea was to have an Acute Visiting Service to do the home visits, as on average one home visit takes up three appointments in surgery. So obviously on seeing the misreported facts, patients became worried and fiercely criticised GPs.

So will 2020 and the next decade be any different to the last decade? I cannot say for certain, but unless difficult decisions are taken the future of our NHS is still under threat.

First Practice Management is here to support PMs throughout 2020 and beyond, so stay tuned to the FPM blog for the news that matters most to Practice Managers. Have you taken a look at our 5 Practice Management Priorities for 2020?


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