Focus turns towards the Long Term Plan

On World Mental Health Day, I received an email from a patient who was abruptly dismissed from work.

He has bipolar personality disorder, anxiety and depression, and I was genuinely terrified he would harm himself because of this. Remotely, we managed to put the support he needed around him and I am going to check in on him daily. It was a stark reminder though how important our relationships with our patients are, and how important it is to look after your mental health as well.

As the weather becomes discernibly cooler, now it feels like activity at NHS England is heating up. Last month I mentioned the long term plan process which has turned our focus clearly towards what needs to be done now – and in the future – to really sustain general practice and primary care.

I try to explore regions and practices on a weekly basis to understand the challenges you are facing and solutions you are coming up with. In Nottingham, two weeks ago, I was inspired by a tennis playing single handed GP who knows the stories of all her patients, and a practice team who have delivered fantastic care despite serious premises issues.

Many of your pressures have been helpfully documented in the GP Partnership Review interim report which sets out the areas the review team have focused on. Please do read it. Alongside this, there is a short myth buster about GP partnership. Please share it, especially with your non partner colleagues as it’s a fantastic resource.

I recently went to Glasgow for the RCGP Annual Conference. This was an inspiring and energising few days where I met so many of you and heard your views and ideas. Thank you for being so candid, and for sharing so openly with me. One of our NHS England non-executive directors, Lord Victor Adebowale, spoke about the role of primary care in addressing health inequalities. Have a read of this paper which tells the story much better than I.

Other stories came up at the conference, including all practices offering cooking classes and group consultations. Whilst these are not part of any specific policy, for some areas holding a weekly Park Run or facilitating a nurse led peer support group around diabetes have been great ways of caring differently in a community – let us know what you are doing, whether it has worked or not!

I genuinely believe learning from each other, and supporting each other is a fantastic opportunity. I recently set up a WhatsApp group for Primary Care Network leaders and the conversations have been both exciting and challenging. We’ve been visiting different networks, and each has a different story to tell, so look out for your local event. Let me know if you’d like to join our WhatsApp group too.

Please do email me your thoughts to

This article was first run in the latest GP Bulletin for October.

NHS England produces a general practice bulletin every month. Sign up now to receive future bulletins.

Dr Nikki Kanani is a GP in south-east London and is Medical Director of Primary Care for NHS England and NHS Improvement. Prior to joining NHS England she was Chief Clinical Officer of NHS Bexley Clinical Commissioning Group (CCG).

Nikki has held a range of positions within healthcare to support the development of innovative models of care, highly engaged clinical, patient and public leadership and is passionate about supporting primary care, improving service provision and population wellbeing.

She is a member of The King’s Fund General Advisory Council and holds a MSc in health care commissioning. With her sister she co-founded STEMMsisters, a social enterprise supporting young people to study science, technology, engineering, maths and medicine. She has two young children.

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