Developing a community-oriented health and well-being service for Cumbria through clinical commissioning: personal reflections

摘要

Key messages class="unordered" style="list-style-type:disc">Initial talent-spotting of motivated and able clinicians to lead commissioning is important.It pays dividends to work alongside commissioners, and provide expertise and experience that they can apply in their own way and in their own time.Capacity-building is a significant task that must continue into the future and extend to large numbers of future professionals.When services are developed by those in closest contact with the public, and when leadership teams include those who span the relevant disciplines and organisations, including public health, and when they together share a vision for whole-population health, there is powerful chemistry.Why this matters to meI am as passionate about general practice as I am about public health and have spent the last 35 years trying to find the common ground between them. Professor Jerry Morris, father of post-war public health in England, once told me that he did not pursue a career in general practice (although he spent some time as a general practitioner) because it was too difficult. He went on to say ‘it is much easier to be a good specialist than a good generalist’. TH Huxley advised that ‘you should know something about everything and everything about something’. The other dichotomy that has to be bridged is between the perspective of the individual patient in the consulting room and the group from which they are drawn. If we could achieve that it would be holism indeed.