Improving access to general practice

The General Practice Forward View published in April 2016 set out plans to enable clinical commissioning groups (CCGs) to commission and fund additional capacity across England to ensure that, by 2020 everyone has improved access to GP services including sufficient routine appointments at evenings and weekends to meet locally determined demand, alongside effective access to out of hours and urgent care services.

The NHS Operational Planning and Contracting Guidance 2017 – 2019 set out the funding trajectory for this work as well as a number of core requirements which commissioners will be required to demonstrate they are meeting.

Refreshed planning guidance published in February 2018, now requires CCGs to provide extended access to GP services, including at evenings and weekends, for 100% of their population by 1 October 2018. This must include ensuring access is available during peak times of demand including bank holidays and across the Easter, Christmas and New Year periods.

Why do we need to improve access

Public satisfaction with general practice remains high, but in recent years patients have increasingly reported, through the GP Patient Survey, more difficulty in accessing services including a decline in good overall experience of making an appointment in general practice.

However, good access is not just about getting an appointment when patients need it. It is also about access to the right person, providing the right care, in the right place at the right time.

Core requirements for improving access

In order to be eligible for recurrent funding, commissioners will need to demonstrate they are meeting seven core requirements for improving access:

Timing of appointments

  • Commission weekday provision of access to pre-bookable and same day appointments to general practice services in evenings (after 6:30pm) – to provide an additional 1.5 hours a day,
  • Commission weekend provision of access to pre-bookable and same day appointments on both Saturdays and Sundays to meet local population needs,
  • Provide robust evidence, based on utilisation rates, for the proposed disposition of services throughout the week.

Capacity

  • Commission a minimum additional 30 minutes consultation capacity per 1000 population, rising to 45 minutes per 1000 population.

Measurement

  • Ensure usage of a nationally commissioned new tool to be introduced during 2017/18 to automatically measure appointment activity by all participating practices, both in-hours and in extended hours. This will enable improvements in matching capacity to times of high demand.

Advertising and ease of access:

  • Ensure services are advertised to patients, including notification on practice websites, notices in local urgent care services and publicity into the community, so that it is clear to patients how they can access these appointments and associated service,
  • Ensure ease of access for patients including:
    • all practice receptionists able to direct patients to the service and offer appointments to extended hours service on the same basis as appointments to non-extended hours services
    • patients should be offered a choice of evening or weekend appointments on an equal footing to core hours appointments.

Digital

  • use of digital approaches to support new models of care in general practice.

Inequalities

  • issues of inequalities in patients’ experience of accessing general practice identified by local evidence and actions to resolve in place.

Effective access to wider whole system services

  • Effective connection to other system services enabling patients to receive the right care from the right professional, including access from and to other primary care and general practice services such as urgent care services.

Queries can be directed to england.gpaccess@nhs.net.

NHS England has created the following slide pack to support the rollout of improved access to general practice, as detailed in the NHS Operational Planning and Contracting Guidance 2017-19.  This slide pack is aimed at general practice staff and commissioners and provides a breakdown of the national core requirements, answers to a number of frequently asked questions and an update on the range of resources that have been made available nationally to support rollout.

Improving access to general practice: accelerating delivery to October 2018

The recently published Refreshing NHS Plans for 2018/19 requires all  CCGs to provide extended access to general practice to their whole population by 1 October 2018. This must include ensuring access is available during peak times of demand, including bank holidays and across the Easter, Christmas and New Year periods. NHS England is continuing its webinar series on general practice access to focus on accelerating delivery, looking at some of the key areas which CCGs will need to consider.

As well as providing an overview from the national team, the webinars will include examples from existing extended access schemes and an opportunity to ask questions on a range of topics relating to implementation.

Webinar dates and links are as follows:

Accelerating Delivery: Improving Patient Satisfaction

Accelerating Delivery: Utilisation Rates

Communications and Engagement