Improving access to general practice

To date, support for improved access to general practice services has been delivered through 57 GP Access Fund pilot schemes, covering more than 2,500 practices and a population of over 18 million people.

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 sets out the funding trajectory for this work, supporting CCGs to deliver extended access as part of delivering the General Practice Forward View.

NHS England has committed to achieving 50% national coverage by March 2018 and 100% of the population by March 2019.

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.

Improving Access to General Practice: Next Steps Webinars

NHS England is hosting two further webinars on the next steps for improving access to general practice, aimed at general practice staff and commissioners. These will repeat content covered through earlier webinars, including the seven core requirements and what this means for those working in general practice, key messages and frequently asked questions, and will provide an update on the range of resources that have been made available nationally to support rollout.

The next webinar will take place on Thursday 12 October 2017 at 9.30am -11.00am with two further webinars, repeating the same content, taking place on:

NHS England will also be hosting a number of subject specific webinars related to improving access. These will initially focus on procurement and communications, as follows: