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General practitioners are a lucky bunch in many ways. A well paid profession that enjoys widespread respect among the community and are largely immune to the often barbed media attention that the NHS attracts.

However, this traditionally media-shy group is about to be thrust into the spotlight as primary care's new decision-makers.

To date, that role has been filled by the country's 152 primary care trusts but, as these close from 2013 as part of the coalition government's radical plan to put GPs in charge of health services, the weight of responsibility will shift squarely onto clinicians' shoulders along with the attention of the media.

Even the world's greatest optimist would be hard pressed to believe that tough decisions around service provision are not on the horizon, especially in light of the coalition government's crusade to reduce ballooning debt and inefficiencies.

It will be a difficult time. There is also sensitivity around what some see as the first steps towards privatisation of the NHS. Supporters of the Government's white paper on health decry such claims as alarmist, while its critics say the public is a sleeping giant yet to be awakened to the implications.

But it is clear that the NHS is as British as tea and rainy summers and its marriage to the national psyche both deep rooted and instinctive. The heart is likely to rule the head when it comes to public support of the NHS and that could mean a rude awakening for its current masters without a clear and comprehensive communications strategy.

GPs will be caught in the middle of this and while many have lobbied for greater decision-making powers, they are also wrestling with the logistics of such a transfer. One of the first challenges GPs face will be acquiring the necessary new skills in dealing with the media.

The consulting room is suddenly looking very small as the media begins to bang on its walls in search of answers to the vision of the future put forward by health secretary Andrew Lansley.

Dr Anil Mehta, a partner in a busy surgery in north east London, is one of the first clinicians to step into the role. NHS Redbridge in north east London has had GPs at the helm for the past year having already transferred 80 per cent of its annual £400 million budget into their hands Dr Mehta is one of five clinical directors responsible for overseeing the new GP-led services in Redbridge, and one of the country's first clinicians to step into the role of spokesman.

He recognises the leap of faith clinicians have to make and has flung himself into media interviews with a gusto that reflects his expanded role.

Mehta says: 'We've been running most of the primary care services in Redbridge for the past year and I have already been interviewed by a number of publications. I enjoy the challenge of getting our message across. It is important to let people know what's going on and the fact that we want to make real improvements to services.

'No-one is denying there is a huge amount of duplication and wastage in the NHS but the beauty is that there are various improvements we can introduce that will save money and lead to a better service for patients. This is the start of a new journey for the NHS and we want to make sure the public are sitting beside us.'

However, it is certainly true that many GPs across the country will have doubts.

Doctors enjoy an enviable position of goodwill in the community, which could be overshadowed when they hold the purse strings and are forced to make difficult decisions.

The shock of seeing their words in print can also come as a surprise, as one of Mehta's fellow practitioners discovered when they were wrongly linked to a story about proposals to relocate the borough's only A&E department.

The GP not only had to contend with the local newspaper ringing the surgery several times for comment but also an irate politician on the warpath after being publicly challenged over some disputed figures.

Mehta remains pragmatic about the media relationship. 'It would be naïve to think it's going to be all sunshine and blue skies, especially as north east London is the first area of the capital to face major service reconfiguration. However, I'm an optimist and, as long as I believe in the worth of something I have no problem going on record.'

Mehta is the first to admit that newspapers, radio and television regard Redbridge as something of a novelty since it is one of first areas in the UK to come under scrutiny with regards to GP commissioning. So how does he find his new role as a local spokesperson on health?

'I'm quite enjoying it although I haven't been on the receiving end of any criticism yet beyond some colleagues joking about seeing my picture in the papers,' he says. 'I've been dealing with the local and national trade press recently who are curious about what is happening because Redbridge is ahead of the game by about a year. People want to learn and I'm delighted to share that expertise.

'The government has highlighted the need for an 'information explosion' and I agree that informing and educating people and more effective signposting is a major area we need to work on. GPs are good communicators on a one-to-one basis but we have to learn to effectively communicate to a wider audience and the government has made it clear that greater public involvement is a condition, not an option.

'There are some huge issues that the public have to understand and act upon, such as more appropriate use of services like A&E. It's no good just blaming the organisation. The NHS is the public and vice versa and that calls for shared ownership and better understanding about what each and everyone of us can do to make it more sustainable.'

For example, a sizable number of people who turn up at A&E would be better treated at urgent care centres. They are likely to be unaware that surgeries are charged £80 for each patient who attends A&E - whether the visit was necessary or not.

Mehta adds: 'We also have to affect a sea change in personal responsibility for health, exercise and diet. People might not like hearing it, but one of the biggest drains on NHS resources is treating diseases and illness that are indirectly caused by unhealthy life styles. 'If we find the key to unlock that problem and make it sustainable that would be a revolutionary turning point in health care. That's our golden egg and we need to get busy incubating it.'

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