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The head of NHS England today (Thursday) sets out a multi-billion plan designed to get general practice back on its feet, improve patient care and access, and invest in new ways of providing primary care.
Publishing a General Practice Forward View – developed with Health Education England and in discussion with the Royal College of GPs and other GP representatives – Simon Stevens said the NHS would now earmark an extra £2.4 billion a year for general practice services by 2020/21.
This means spending will rise from £9.6 billion in 2016/17 to over £12 billion by 2021 – a 14 percent real terms increase. This investment will be supplemented by a £500 million national ‘turnaround’ package to support GP practices, and additional funds from local clinical commissioning groups (CCGs).
The plan also contains specific, practical and funded steps to strengthen workforce, drive efficiencies in workload, modernise infrastructure and technology, and redesign the way modern primary care is offered to patients.
On workforce it details action to double the growth rate in GPs, through new incentives for training, recruitment, retention and return to practice. Having taken the past 10 years to achieve a net increase of around 5,000 full time equivalent GPs, the aiming to add a further 5,000 net in just the next five years. In addition, 3,000 new fully funded practice-based mental health therapists, an extra 1,500 co-funded practice clinical pharmacists, and nationally funded support for practice nurses, physician assistants, practice managers and receptionists.
On workload the plan sets out a new practice resilience programme to support struggling practices, changes to streamline the Care Quality Commission inspection regime, support for GPs suffering from burnout and stress, cuts in red-tape, legal limits on administrative burdens at the hospital/GP interface, and action to cut inappropriate demand on general practice.
On infrastructure it proposes upgrades to practice premises, new proposals to allow up to 100% reimbursement of premises developments, direct practice investment tech to support better online tools and appointment, consultation and workload management systems, and better record sharing to support team work across practices.
On care redesign it signals practical support for individual practices and for federations and super-partnerships; direct funding for improved in hours and out of hours access, including clinical hubs and reformed urgent care; and a new voluntary GP contract supporting integrated primary and community health services.
Simon Stevens said: “GPs are by far the largest branch of British medicine, and as a recent British Medical Journal headline put it – if general practice fails, the whole NHS fails. So if anyone ten years ago had said: “Here’s what the NHS should now do – cut the share of funding for primary care and grow the number of hospital specialists three times faster than GPs”, they’d have been laughed out of court.
But looking back over a decade, that’s exactly what’s happened. Which is why it’s no great surprise that a recent international survey revealed British GPs are under far greater pressure than their counterparts, with rising workload matched by growing patient concerns about convenient access. So rather than ignore these real pressures, the NHS has at last begun openly acknowledging them. Now we need to act, and this plan sets out exactly how.”
Arvind Madan, NHS England Director of Primary Care and a Tower Hamlets GP, said “We are acutely aware of the pressures GPs are facing right now and the need to get on track as quickly as possible. This means that practices, working together, will benefit from access to support if they are struggling to meet patient’s needs, reductions in unnecessary workload, more opportunities to recruit staff and a chance to improve use of their technology or premises”.
“We know this is just the start of the journey but we are determined to get this right for the benefit of patients, GPs and the wider healthcare system.”