Response, resilience and sustainability

General practice is the heart of the NHS, and the NHS relies on it to survive and thrive.

The pandemic has presented the NHS with its greatest challenge since it was established in 1948. Despite already coping with growing demand General Practice rose to the challenge of continuing to work during unprecedented and extremely difficult times. Rapid and widescale changes to traditional ways of working have been implemented in order to provide safe and accessible care to patients, with primary care teams embracing digital tools such as remote working, online triage, online, video and telephone consultations.

The importance of strong clinical and digital leadership to enable digital transformation has been robustly demonstrated, supporting and promoting the accelerated and widespread adoption of digital tools by General Practice. These have enabled more efficient, flexible and resilient ways of working. This has helped practices to meet growing demand from patients by providing choice of digital channels, supporting transformation and innovation for modern general practice.

The publication of this 5th Operating Model for General Practice Digital Services comes at an extremely pertinent time, building on and sustaining the achievements and lessons learned during the pandemic and providing the framework to maintain the momentum of change.

Recent events have shown that for general practice, business continuity and resilience is the ability to respond to major events and new priorities, while also ensuring sufficient flexibility to rapidly reconfigure and realign as needed to maintain business as usual activity. Providing the capability for such resilience and flexibility whilst continuing to ensure the safety of General Practice is a key theme of this Operating Model. There is understandably high public expectation of patient safety and data security in our electronic patient record systems.

Although still a core practice responsibility the critical importance of modern advanced telephony systems in general practice is recognised and we have taken a number of steps to support and guide practices in this area.

We are starting to see the impacts of Primary Care Networks (PCNs) and recognise that ensuring the availability of the right technologies and support are essential to their success.

As Integrated Care System (ICS) organisations are established, digital tools and electronic communications enabled by readily accessible shared infrastructure across local health systems are critical. The next iteration of this Operating Model will require significant change to align with Integrated Care Boards (ICBs).

In addition 2020 saw a major commitment to deliver a net zero NHS by 2040. In general practice, digital systems and tools that reduce staff and patient travel and continue to progress towards a paper free environment for patient records are important enablers to reduce our carbon footprint.

Of course the technologies are only enablers and although we clearly need digital tools, infrastructure and support fit for use, it is our staff and our patients who need the access, confidence and skills to use them to the full to realise the benefits.

This Operating Model continues to recognise the challenges faced in general practice and the need for Clinical Commissioning Groups (CCGs) to continue to ensure investment is directed appropriately. It remains critical that commissioners responsible for the provision of GP IT services are fully aware of and enact the requirements of the Operating Model. It is vital that digital service delivery, transformation and innovation continues to be at the forefront in supporting new models of care

We are grateful for the support of NHS colleagues, CCGs, General Practice, BMA, RCGP and GP IT Delivery Partners that have contributed to the development of this framework.

Lloyd Baker, Programme Director, Digital Primary Care, NHS Transformation Directorate, NHS England.

Guidance contents

Download a PDF copy of ‘Securing Excellence in Primary Care (GP) Digital Services: The Primary Care (GP) Digital Services Operating Model 2021-2023’