Supporting general practice leadership
By Dr Sarah Schofield
FMLM Founding Senior Fellow and advising associate in general practice
Like all change, the merger of clinical commissioning groups (CCGs) and the development of integrated care systems (ICSs) in England will bring opportunities to some. Due to such local organisational change, I am delighted to become more involved with FMLM. After the past 18 months of Covid, many people are reflecting on their priorities, and, for me, this is a great opportunity to focus on the importance of primary care clinical leadership.
As a GP leader, I have enjoyed the support of other FMLM fellows and members, recognising the value of FMLM’s Leadership and Management Standards for Medical Professionals as a benchmark of quality in all clinical leadership. It is always a disappointment to hear that some primary care leaders still believe FMLM is focussed on secondary care. I am looking forward to working towards dispelling that myth.
General practice and primary care clinical leaders are vital participants in local models of healthcare, and their voices should be heard throughout the NHS for the benefit of patients and colleagues. FMLM has always been keen to welcome, work with and support GPs and primary care colleagues and wants to ensure that is reflected through the value of its offer and approach, as well as through its membership and fellowship.
With more than 80 per cent of healthcare contacts taking place in primary care, why would general practice not be a vital part of any system reset or redesign? Primary care clinical leaders, with each reorganisation of the NHS, are given new roles and objectives. I took my first formal senior leadership role in England in the days of primary care groups (PCGs) with my last as clinical chairman of a CCG, with several roles in between, working for other NHS organisations in England, all with three-letter acronyms.
Those of us with clinical commissioning experience have developed knowledge and skills working across organisational boundaries, both within the NHS and outside, across primary and secondary care, mental health, and community care, within our local communities of patients and in the voluntary sector. These skills should be of value to the burgeoning ICSs in England. Of course, these systems have matured in Scotland and Wales, but with mergers of CCGs likely to continue, CCG clinical leaders should have new opportunities to bring their system experience to the work, both strategic and operational, of the new NHS structures in England.
Primary care networks (PCNs) are one of the new building blocks of the ICS systems. They were designed prior to Covid, but with the pandemic our PCN leaders have demonstrated their important role in local systems. PCN clinical directors could never have imagined how different their roles could become from that of their original job description. PCNs have led the approach to supporting patients outside hospitals throughout the pandemic; that includes the work with care homes, clinical hubs, vaccination programmes, not to mention supporting patients on waiting lists, those with long term conditions and new diagnoses. The clinical directors have proved their ability to work across organisations for the benefit of their own populations (30-50,000 people) as well as the wider system.
Covid has provided an opportunity for many PCNs to work together. Now, the PCN clinical directors have a role in leadership across the system to help address the backlog in acute care. Supporting the development of PCN clinical directors as well as giving them a rightful voice at the ICS table is one of the objectives of NHS England/Improvement. FMLM has a powerful opportunity to support such development and benefiting the wider NHS in the UK by increasing the focus on our primary care clinical leaders. I welcome the opportunity to be part of that work.