1. Together for Health Dr. Chris Price Deputy Director Revalidation Support Unit Wales Deanery

3. My perspective as a GP 22 years in practice Changes –Busier –More complex cases in the community –Healthier elderly population (more drugs) –Access and demand (in hours/OOH) –Diagnostic facilities –Knowledge expansion (the generalist)

4. My perspective as a GP GP contract Individuals working with teams Practice based teams of HV Midwives and DNs gone 24 hour care – GP/hospital Less contact with consultants Less ability to obtain urgent opinion

5. My perspective as a GP Together for health –Partnership between the public and NHS –(even) more prevention (targeted) –“GP teams will do more” –Grouped in localities –More complex cases treated at home –Specialist acute facilities + DGH (transfers)

6. My perspective as a GP Examples in action Locality groupings starting – give them a chance Intermediate care – now extending hours Earlier discharge (as yet unsupported) Access to tests (MRI, endoscopy, echo etc.) good but slow

7. My perspective in deanery role GP CPD Appraisal Revalidation

8. My perspective in deanery role GPs will need to develop in their roles Already many act as GPwSI or clinical assistants GP training produces GPs CPD for extended roles Appraisal for extended roles Revalidation for extended roles

9. Challenges Medical recruitment into training grades Current system is under strain –Waiting lists –Recruitment (regional and specialty issues) –GP OOH –Demand and expectation –European working time directive

10. Perhaps time ripe for change As a consumer –Access –Convenience –Quality –Feedback (that is utilised) –Safety –Evidence based practice

11. Finally Do I agree with Together for Health? Can we shift from the 1’/2’ care model? Can we do quality and volume? Will revalidation have an impact? (particularly with WPA)