TY - JOUR T1 - General practice under the hammer JF - British Journal of General Practice JO - Br J Gen Pract SP - 368 LP - 369 DO - 10.3399/bjgp08X280344 VL - 58 IS - 550 AU - Ashley Liston Y1 - 2008/05/01 UR - http://bjgp.org/content/58/550/368.abstract N2 - The best career decision I have made so far was to leave my partnership in a pleasant practice in a nice part of Newcastle to work in a struggling practice in a needy part of Sunderland as a salaried GP. At the age of 47 this might very reasonably be to a straightforward case of mid-life crisis. The notion of really ‘making a difference’ in the world is something that often appeals when one sees less years ahead of you than are behind you. The real motivation was probably much more to do with people like Julian Tudor Hart who coined the phrase ‘The Inverse Care Law’ and spent his life trying to address it in a deprived mining community in Wales.The practice I joined had been unable to recruit a GP for over 2 years, being reliant entirely on GP locum support. Despite the huge challenge facing them, they had continued to provide a personal and caring service to ‘their’ patients through sheer determination and hard work. My role was simply to act as a catalyst for a team who already epitomised the best of the NHS with their enormous commitment and goodwill in seeking to provide the best of care with very limited resources.The practice quickly developed, soon becoming a GP training practice and achieving nearly full QOF points. The patients repeatedly expressed their delight at once again ‘having their own doctors’ and especially ‘having doctors who listened’. The PCT meanwhile were starting to progress their plans to let go of the management of the practice. They were clearly under some pressure to focus on commissioning rather than providing but also to develop a … ER -