Population Health Research Institute, St George's University of London, London, UK (Mr Razai); and Department of Primary Care & Public Health, School of Public Health, Imperial College London, London, UK (Dr Majeed).
J Ambul Care Manage. 2022;45(2):135-139. doi: 10.1097/JAC.0000000000000410.
General practice or family medicine has historically been lauded as the "jewel in the crown" of the English National Health Service (NHS) (M. Marshall, 2015). General practice, at the heart of primary care, has continued to contribute to the high ranking of the NHS in international comparisons (M. S. Razai & A. Majeed, 2021) and evidence from several decades of research has shown that general practice in the UK has improved the nation's health (Royal College of General Practitioners, 2013). Furthermore, it has provided equitable, cost-effective, and accessible care for all with the flexibility to adapt rapidly to a changing society and political climates, such as during the COVID-19 pandemic when there was rapid implementation of remote consultation models (Royal College of General Practitioners, 2013). However, this much-admired public sector service has recently come under unprecedented political and media spotlight instigated by the pressures of the current pandemic on the NHS (M. S. Razai & A. Majeed, 2021). This coupled with collapsing morale among general practitioners (GPs), a shrinking GP workforce, inexorable demands, increasing workload, and decreasing real-terms per capita funding have caused many to sound alarm on a general practice in "crisis" (C. Gerada, 2021). In this article, we describe the evolving nature of general practice and the current crisis, as well as potential solutions and opportunities going forward.
全科医学或家庭医学历来被誉为英国国家医疗服务体系（NHS）的“皇冠上的明珠”（M. Marshall，2015）。作为初级保健的核心，全科医学在国际比较中继续为 NHS 的高排名做出贡献（M. S. Razai 和 A. Majeed，2021），几十年来的研究证据表明，英国的全科医学改善了国民健康（皇家全科医生学院，2013）。此外，它为所有人提供了公平、具有成本效益且可及的护理，并具有迅速适应不断变化的社会和政治环境的灵活性，例如在 COVID-19 大流行期间，迅速实施了远程咨询模式（皇家全科医生学院，2013）。然而，这项备受赞誉的公共部门服务最近受到了前所未有的政治和媒体关注，原因是 NHS 目前面临着疫情的压力（M. S. Razai 和 A. Majeed，2021）。再加上全科医生（GP）士气低落、GP 劳动力萎缩、不可避免的需求、工作量增加和人均实际资金减少，许多人对全科医学“危机”发出了警报（C. Gerada，2021）。在本文中，我们描述了全科医学的演变性质和当前的危机，以及未来的潜在解决方案和机遇。
