26 June 2012

‘Experts in Whole Person Medicine’ – College Makes Compelling Case for Future Role of Generalist

The vital role of the “medical generalist” must be more widely recognised and enhanced if the NHS is to meet the challenges facing it, according to a landmark report launched by the RCGP today.

The College sets out a compelling case for why medical generalists – “experts in whole person medicine” – matter to all healthcare systems. It opens the debate on why the importance and influence of the role needs to be given fresh consideration within a much wider context than general practice and primary care.

The report describes how medical generalists provide care that is both focused on individual wellbeing and delivers wider benefits, helping to ensure that the NHS remains one of the most cost-effective health systems in the world. The RCGP calls for general practitioners to be given more support to protect and enhance their vital role, including longer training; more time with patients; better access to diagnostics and better communication with specialists.

The report is the RCGP’s formal response to the findings of the independent Commission on Generalism. It outlines the College’s overall position on the future of medical generalism, explores the challenges raised in the Commission’s report and proposes a programme of work to address issues such as continuity and access.

The RCGP has identified ten priority areas which aim to review the disciplines of General Practitioners and other medical generalists from different perspectives and ensure they are equipped to meet the changing needs of their patients:

  • Effective use of patient feedback
  • Policy on out of hours care
  • Development of generalist models of care for complex and chronic conditions in the community
  • Improved communication between GPs and specialists
  • Extended training for GPs
  • Enhanced training in paediatric care, learning disabilities, mental health, palliative and end of life care
  • GP-led commissioning
  • Further research into multiple morbidities and early, accurate diagnosis in primary care
  • Use of IT, data sharing and inter-agency e-communications
  • Nursing home care.

The Independent Commission on Generalism was established by the RCGP in partnership with the Health Foundation in March 2011 to examine the contribution and role of General Practitioners and generalists in the healthcare system.

Chaired by  Baroness Ilora Finlay, the Commission found that overall, generalists and GPs were so important in the NHS that “if they did not currently exist, they would have to be invented”.

In compiling its report, “Medical Generalism. Why expertise in the whole person medicine matters”, the RCGP consulted widely with its members and other stakeholders using a variety of channels including debates and regional listening exercises.

RCGP Honorary Secretary Professor Amanda Howe who is leading the work, said: “Generalists are professionals who are committed to the patient as a person. They retain responsibility for patients over time, deal with many issues and help patients to make judgements that are safe for them and the system.

“Whether a practitioners is a true generalist or not depends on their training, their attitudes, their scope of practice, and frequently their work setting. There is a difference between a generalist and using generalist skills.

“The GP remains the front door and the community interface of the NHS and principles of practice are still based on two key concepts: holistic and patient-centred care. Our report shows that GPs are very positive about seeing the basis of our discipline from a new perspective and are keen to have the value and skills of medical generalists more strongly supported across the modern NHS.

“We now invite others across the clinical and political spectrum to engage with the next steps which will make medical generalism a real force for effective and efficient personalised healthcare in the 21st century NHS.”

Adrian Sieff, Assistant Director at the Health Foundation, said: “We are pleased to have supported the College in responding to the Commission’s report. We welcome the commitment of General Practitioners to the patient as a whole person. Seeing the person in the patient and understanding the needs, wishes and priorities of each individual is vital to improving the quality of healthcare. It is not easy to truly achieve “whole person medicine” and we welcome the College’s continuing leadership in taking forward work to explore how to make this real in primary care.”


RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659 


The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

Medical generalism: Why expertise in whole person medicine matters is available to download from www.rcgp.org.uk/medicalgeneralism.

The Commission on Generalism was established in March 2011 to examine the contribution of medical generalism and the role of the generalist in today’s healthcare system.

It’s aims were to:

  • Agree a definition for generalism
  • Instigate a structured discussion of the rationale for, and the current status of, medical generalism
  • Make an analysis of the effectiveness of, and any problems associated with, generalist practice
  • Make recommendations for the future direction of the generalist role, with reference to workforce planning
  • Consider how clinical training for general practice and some other specialities retain key elements of generalism to deliver effective patient care; and
  • Consider the drivers for change such as demography, science and technology, medical training, the economy, social trends, and political factors. 

Chaired by Baroness Ilora Finlay, the panel included former Chair and President of the RCGP Professor David Haslam; Harry Cayton, Chief Executive of the Council for Healthcare Regulatory Excellence; Dr Anna Dixon, Director of Policy at the King’s Fund; and Baroness Sheila Hollins, Professor of Psychiatry of learning disability at St George’s (University of London) and crossbench life peer.