Skill-mix change and the general practice workforce challenge

The workforce challenge described by Pauline Nelson concludes that "skill mix change is recommended in primary care but may not always achieve the intended aims". As a 5000 patient GP surgery in the East Midlands, an area significantly under-populated by GPs, we changed our practice skill mix in 2016 with incredible outcomes. For this reason I would encourage other GPs to look at our model of care. If the skill mix change is completed for the right reason, to enhance patient care, and not because of lack of GPs or increasing patient demand, it can and does work. We now work as "GP consultants", no just as GPs, a term we believe is essential for the future of general practice, to improve our morale and to inspire our future workforce to choose GP. We supervise our excellent team of nurse practitioners, paramedics, pharmacists, nurses, medical students and HCAs whilst they see the patients, update medication and deal with routine enquires. Because of the skill mix change, as GPs we can now oversee every patient contact that needs our high level skills, spend more time with complicated patients and at the end of most days have spare appointments that are not used and on most days leave the practice on time. We are true specialists as GPs and it is time that was recognised. As our secondary care colleagues have a team who work with them, so should we. The time for isolation is primary care is over. Think of yourself as a "GP consultant" and create an effective and highly skilled team around you where each person works to their own unique skill mix, leaving the "consultant" to supervise, inspire, educate and nurture those around them.