Health

The traditional partnership model in general practice, long considered the bedrock of primary care in England, is facing a decline in its appeal among GPs, according to recent survey data. While a majority still favor the structure, a significantly smaller proportion express a willingness to take on the role, raising concerns about the future of this practice arrangement and potential implications for patient care.

The findings, stemming from a survey conducted by the Royal College of General Practitioners (RCGP), highlight a growing reluctance among doctors to embrace the responsibilities and challenges associated with partnership. This shift comes amidst increasing pressures on general practice, including rising workloads, complex patient needs, and administrative burdens. The survey data underscores a potential crisis in recruitment and retention within the partnership model, potentially impacting the stability and continuity of care for patients across the National Health Service (NHS).

The RCGP survey, which polled 2,317 GPs in England – with 1,645 actively practicing – revealed that while most GPs still support the partnership model, fewer than a third (31%) indicated they were likely to become partners. This represents a notable decrease in enthusiasm compared to previous years, signaling a potential long-term trend. The data points to a growing preference for salaried positions or other employment arrangements that offer greater work-life balance and reduced financial risk. Medscape News UK reported on the findings earlier today.

Workload and Wellbeing as Key Factors

The decline in partnership appeal is closely linked to the intense pressures facing general practice. GPs consistently report unsustainable workloads, increasing demand for appointments, and a growing complexity of patient cases. These factors contribute to burnout and compassion fatigue, making the prospect of taking on the additional responsibilities of partnership – including financial liabilities and management duties – less attractive. Recent research has emphasized the importance of addressing compassion fatigue among GPs to safeguard both their wellbeing and the quality of patient care.

The survey data aligns with broader concerns about the future of general practice in the UK. A November 2025 survey of over 2,100 GPs and registrars highlighted the risks to patient safety posed by heavy workloads. The RCGP has been actively advocating for increased investment in general practice and measures to reduce administrative burdens on GPs, but progress has been slow.

AI Adoption and the Changing Landscape

The evolving landscape of healthcare, particularly the increasing adoption of artificial intelligence (AI) tools, is also influencing GPs’ perspectives on partnership. While many GPs are embracing AI to streamline administrative tasks and improve diagnostic accuracy, there are concerns about the lack of adequate oversight and regulation in this area. Reports indicate that GPs are navigating an “AI wild west” with patchy guidance, potentially impacting their confidence in adopting these technologies within a partnership structure.

The RCGP’s annual conference in 2025 also addressed key issues impacting the profession, including debates surrounding prostate-specific antigen (PSA) testing and the demand for clearer guidance. Conference news from Medscape highlighted the ongoing discussions and challenges facing GPs.

The shift away from partnership could have significant consequences for the NHS. Partnerships often foster a sense of ownership and commitment to the local community, leading to more proactive and personalized care. A decline in partnerships could result in a more fragmented and less responsive primary care system. The loss of experienced partners could exacerbate existing workforce shortages and further strain the capacity of general practice.

Looking ahead, addressing the underlying issues driving the decline in partnership appeal will be crucial. This includes increasing investment in general practice, reducing administrative burdens, supporting GP wellbeing, and providing clear guidance on the integration of new technologies like AI. The RCGP and other stakeholders will need to work collaboratively to develop sustainable solutions that ensure the long-term viability of the partnership model and the future of primary care in England.

What do you think should be done to revitalize the GP partnership model? Share your thoughts in the comments below. Please also share this article with your colleagues and networks to raise awareness of this important issue.

Disclaimer: This article provides informational content and should not be considered medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

A Tipperary dentist has been sentenced to one year in prison and ordered to pay €100,000 to the Health Service Executive (HSE) after admitting to defrauding the state healthcare system of €58,000 over a period of 17 years. The case, which highlights vulnerabilities within Ireland’s Dental Treatment Service Scheme (DTSS), underscores the importance of robust oversight in public healthcare spending.

Jerome Kiely, 47, of Acraboy House, Monard, Co Tipperary, pleaded guilty last November at Dublin Circuit Criminal Court to multiple counts of deception. The offenses involved falsely claiming payments for dental procedures, including dentures, that were never performed. The systematic nature of the fraud, spanning from 2008 to 2025, involved forging patient signatures and altering records to support the false claims, according to court documents.

Judge Martin Nolan, in sentencing Kiely on Monday, stated that the dentist had “brought utter ruination on himself” and that the HSE’s trust had been “misplaced.” Despite acknowledging Kiely’s mental health struggles, including a lengthy history of depression and increasing reclusiveness, the judge emphasized the deliberate and calculated nature of the fraud. The court heard that Kiely appeared to have sufficient financial resources, raising questions about the motivation behind the offenses.

Details of the Fraudulent Scheme

The investigation, conducted by the Garda National Economic Crime Bureau (GNECB), revealed that Kiely exploited the Dental Treatment Services Scheme, which provides dental care to adult medical card holders. The scheme covers treatments such as fillings, extractions, root canals, and dentures. Investigators examined 79 separate incidents of deception, supported by 56 patient statements, and interviewed 131 patients.

Proven fraudulent claims totaled €58,000, but investigators believe the actual amount defrauded from the HSE is significantly higher. Two bank accounts linked to Kiely, containing approximately €830,000 and €667,000 respectively, have been frozen pending further investigation and potential recovery of funds.

Financial Implications and Patient Impact

The case raises concerns about the potential for abuse within the medical card scheme and the impact on vulnerable patients, particularly the elderly. The GNECB investigation highlighted the need for stronger safeguards to prevent similar fraudulent activities in the future. The fraudulent activity occurred even after Kiely’s initial arrest, demonstrating a persistent pattern of deception.

Kiely had no previous convictions. The court received letters of support, including one from his wife and references from the local GAA club, where he volunteered. However, Judge Nolan questioned whether Kiely would be able to continue practicing dentistry following his conviction.

Future Oversight and Healthcare Security

The sentencing of Jerome Kiely serves as a stark reminder of the importance of accountability and transparency within the healthcare system. The HSE will likely review its procedures and controls to minimize the risk of similar fraudulent schemes. Further investigation is expected to determine the full extent of the financial losses and to explore potential avenues for recovering the defrauded funds.

The case also underscores the need for ongoing vigilance and robust monitoring of healthcare claims to protect public resources and ensure the integrity of the system. The GNECB will continue to investigate and prosecute cases of healthcare fraud to deter future offenses.

Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical or legal advice. It is essential to consult with qualified professionals for any health concerns or legal matters.

What are your thoughts on this case? Share your comments below, and please share this article with your network.

For patients facing the daunting diagnosis of multiple brain metastases, a new approach to radiation therapy is offering a significant improvement in quality of life. A recent randomized clinical trial demonstrates that stereotactic radiation therapy (SRS) – a highly focused form of radiation – leads to less symptom burden and better functional outcomes compared to traditional whole-brain radiation therapy (WBRT), particularly when hippocampal avoidance techniques are employed.

Brain metastases, where cancer spreads from another part of the body to the brain, affect an estimated 20% of all cancer patients, with roughly 200,000 individuals in the United States receiving treatment annually [1]. Although advancements in cancer treatment are helping patients live longer, concerns have grown regarding the neurocognitive toxicities associated with WBRT. This trial, led by researchers including Paul Brown, MD, of the Mayo Clinic, offers a promising alternative.

SRS Shows Benefit in Multiple Brain Metastases

The study, focusing on patients with 5-20 brain metastases, revealed that SRS resulted in significantly less symptom burden compared to hippocampal-avoidance whole-brain radiation therapy (HA-WBRT). Patients receiving SRS likewise demonstrated better performance in activities of daily living (ADL), cognitive function, and Karnofsky Performance Status (KPS) – a measure of a patient’s overall well-being [3]. These findings suggest that SRS is rapidly becoming the standard of care for this patient population.

Paul Brown, a Radiation Oncologist at Mayo Clinic, shared the trial results on LinkedIn, highlighting the positive impact of SRS on patient well-being [3]. The trial involved a comprehensive team of researchers, including Ayal Aizer, Kee-Young Shin, Paul Catalano, and many others, demonstrating a collaborative effort to improve treatment outcomes.

Hippocampal Avoidance and the Evolution of WBRT

Traditionally, WBRT delivered radiation to the entire brain. However, this approach can lead to significant neurocognitive side effects. Recent advancements have focused on refining WBRT techniques, such as hippocampal avoidance, which aims to spare the hippocampus – a brain region crucial for memory – from radiation exposure [1]. While hippocampal avoidance WBRT represents an improvement over traditional WBRT, the new trial data suggests that SRS offers even greater benefits in terms of quality of life.

The shift towards more targeted therapies like SRS reflects a broader trend in cancer treatment, prioritizing precision and minimizing collateral damage to healthy tissues. This approach aligns with ongoing research into innovative radiation techniques, including tumor treating fields, which utilize electric fields to disrupt cancer cell growth [1].

Implications for Future Treatment Guidelines

The results of this randomized clinical trial are poised to influence future treatment guidelines for patients with multiple brain metastases. The American Society for Radiation Oncology (ASTRO), along with the Society for Neuro-Oncology (SNO) and the American Society of Clinical Oncology (ASCO), have previously established guidelines for managing brain metastases, but these are continually evolving as new evidence emerges [4]. The demonstrated benefits of SRS in preserving cognitive function and improving overall quality of life are likely to be incorporated into updated recommendations.

Paul D. Brown, MD, at the Mayo Clinic, specializes in GammaKnife and spine stereotactic radiosurgery, as well as adult brain and spine tumors, and proton radiotherapy [2]. His work, along with that of his colleagues, is at the forefront of advancing treatment options for patients with brain metastases.

Further research is ongoing to determine the optimal sequencing of therapies – whether SRS should be used as a first-line treatment or in combination with other modalities, such as systemic therapy. The ultimate goal is to personalize treatment plans to maximize efficacy and minimize side effects for each individual patient.

This is a rapidly evolving field, and continued investigation into novel treatment strategies is crucial for improving the lives of those affected by brain metastases. Share your thoughts and experiences in the comments below.

Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.