Today, NHS England has published the General Practice Forward View, setting out support for primary care over the next five years.
This strategy has been long-awaited by the profession. Key elements in this roadmap represent the culmination of many years of lobbying and calls for action by GPC.
We have worked closely with NHS England to influence its final strategy, by representing the profession and stressing the urgency for support and investment in general practice.
NHS England has accepted a large number of our proposals from our most recent paper Responsive, safe and sustainable: our urgent prescription for general practice,which sets out the urgent actions that need to be taken to alleviate the current significant pressures on the service. These include:
- Fair and sustainable funding and resources
— £2.4bn to be invested recurrently in general practice, increasing NHS England’s general practice spend to a minimum of 10.4 per cent by 2020, rising further with supplementation by CCG investment
— A £500m sustainability and transformation package that includes £56m for a practice resilience programme; £246m to support practices in redesigning services, and which includes transformational support to work collaboratively
— Measures to tackle rising costs of indemnity
- Reducing workload and bureaucracy
— A three-year £30m ‘Time to Care’ programme to release up to 10 per cent of inappropriate GP time
— Amending the NHS Standard Contract to reduce inappropriate workload shift by ensuring that hospitals no longer refer patients back to GPs for re-referral, and also that hospitals are able to make internal referrals where this is for a related condition. Additionally, communicating the results of hospital investigations must be the responsibility of the hospital, not the GP
— A national approach on reducing bureaucracy and workload management, including promotion of self-care and appropriate use of GP services
— The possibility of ‘locality hubs’ to refer patients when practices reach capacity
- An expanded workforce
— £206m for workforce measures to grow the medical and non-medical workforce
— New £112m funding for 1,500 more pharmacists working in general practice by 2020
— £15m for practice nurse development
— £50m to support training of reception, clerical and practice manager staff
— £16 for specialist mental health services
— Investment in an extra 3,000 mental health workers to support practices by 2020
- Reducing the regulatory burden of the CQC
— NHS England commitment to reduce the number of inspections to every five years, and to recompense practices for future increases in CQC fees
— GPC will continue to argue for radical scaling down and an overhaul of current regulatory systems, and that CQC fees should be fully reimbursed
- Infrastructure and technology to deliver practice and system resilience
— £900m for capital investment and including new rules on premises costs to enable NHS England to fund up to 100 per cent of the costs for premises developments
— 18.5 per cent increase in revenue funding of CCGs for GP IT services and technology
- Empowering patients
— Funding for workforce and technology to support practices in assisting patients to manage minor self-limiting illnesses, for example using online resources or training care navigators
— Signposting of patients to self-care and minor ailment schemes
We are clear that NHS England’s proposals are a much-needed, if overdue, acknowledgment of the state of general practice and build on what GPC has been lobbying for over the last three years. As such, they represent a significant and comprehensive package to support general practice, both in the immediate and longer term.
At the same time, we are equally clear that there are a number of areas that require a lot more clarity, as well as other areas that do not go far enough. There are also important elements set out in the GPC’s Responsive, safe and sustainable: our urgent prescription for general practice that are yet to be acknowledged and addressed. You can be absolutely confident that we will continue to work to ensure that these are also addressed.
We believe this document is a framework for what needs to now happen, with many of the proposals and funding a floor not a ceiling. Working out the detail and implementing these plans is critical and we have therefore secured a commitment that an Advisory Oversight group, on which the BMA, RCGP and patients will sit, will be created to steer and drive the implementation of the measures.
In order for this framework to have the confidence of GPs, it is critical that they see tangible and rapid delivery against these commitments.
GPC will continue its work to ensure that NHS England’s words are translated into action so that practices receive the support that is so urgently needed.
- Read our news story: Funding boost for primary care
- Read NHS England’s story: NHS England backs general practice with a multi-billion transformation plan
With best wishes
BMA GPs Committee Chair