TY - JOUR T1 - Is the future of general practice safe for patients? JF - British Journal of General Practice JO - Br J Gen Pract SP - 257 LP - 258 DO - 10.3399/bjgp19X702629 VL - 69 IS - 682 AU - Ian Bennett-Britton AU - Chris Salisbury Y1 - 2019/05/01 UR - http://bjgp.org/content/69/682/257.abstract N2 - General practice is changing rapidly, driven by policy demands for new models of care to address an expanding, ageing, and increasingly medically complex population.1 Such change presents opportunities to improve all aspects of care; however, questions remain about the risks to patient safety. These risks can be grouped into: those related to changes in workforce and workload; those related to changes in infrastructure and models of care; and those related to limitations of existing mandatory patient safety systems in general practice.The General Practice Forward View1 (GPFV) set out NHS England’s strategy for general practice up to 2020, committing to 5000 additional doctors and a minimum of 5000 other staff, including mental health therapists, clinical pharmacists, and physician associates (PAs). The roles of new and existing staff are expanding to more efficiently use GP capacity. Although investment in general practice is welcomed, there is uncertainty regarding safe limits of delegation and supervision of staff in existing and new roles.Some of the risks surrounding the workforce changes are illustrated by the GPFV’s commitment to increasing PA numbers, from 31 known to be working in general practice in 2016, to 1000 by 2020.2 PAs are presently regulated on a voluntary basis despite commitments to rapid expansion of the role since 2016. Fortunately, in October 2018, the Department of Health committed to developing statutory regulation for PAs.3 However, the value of this will be defined by its terms. The clinical governance arrangements under which PAs may work remain … ER -