What’s been happening in general practice?
Updated 11 August 2023.
It’s an incredibly busy time for general practice and continues to be. We’ve summarised some of the key activities for easy reference.
- Updated planning and guidance
- General practice contract arrangements in 2023
- Care navigation training
- National primary care clinical pathway for constipation in children
- How to identify and support unpaid carers
- Offering patients access to their future health information
- Infection prevention and control
- Improving access
- Public facing resources
- Growing and supporting our workforce
- Coaching and wellbeing support
- COVID-19 updates
Long term workforce plan
The long term workforce plan sets out clear proposals for government and the practical steps we can take to ensure the NHS has the number of staff it needs across the country with the tools they need to deliver the best care possible. The certainty of confirmed funding allows us to take pragmatic actions locally, regionally, and nationally.
Some of the key highlights for primary care include:
- further expanding the number of GP training places available and building on the success of the Additional Roles Reimbursement Scheme (ARRS)
- pharmacists will benefit from an expansion of training places and of clinical role, and consideration of a pharmacist degree apprenticeship.
- the number of training places available for dentists, dental therapists, and hygienists will be expanded.
- the number of education and training places for the Allied Health Professional (AHP) workforce will grow, by increasing the proportion of AHPs who train via apprenticeships.
This plan is not just about increasing numbers, it is about working differently to maximise the benefit of new technology, therapies and treatment. It is also about retaining the staff we have – by boosting flexibility in roles and supporting the wellbeing of our staff, we can ensure fewer staff leave the NHS over the next 15 years.
Delivery plan for recovering access to primary care
A joint NHS and Department of Health and Social Care Delivery Plan for Recovering Access to Primary Care was published on 9 May 2023.
It sets out how the NHS will make it easier and more convenient for patients to get the help they need from primary care services and is an important first step in delivering the vision set out in Dr Claire Fuller’s stocktake: ‘Next steps for integrating primary care’.
Developed and informed with the expertise and insight from a wide range of health partners, the delivery plan focuses on improving access to general practice, a key commitment in the government’s Autumn Statement.
Demands on general practice have never been greater, with record numbers of appointments being delivered – half a million more every week compared with pre-pandemic. While patient satisfaction with the care received from general practice teams remains high, patients’ experience of accessing their surgery has seen a significant drop over the past year.
Supported by investment, the new blueprint sets out actions to modernise general practice, which come into effect over the coming months, to improve access to care by tackling the 8am rush and reducing the number of people struggling to contact their practice; restoring patient satisfaction of accessing their practice; and supporting a move to a digitally-enabled operating model in general practice.
Proposals to expand the vital role of community pharmacies by consulting on a Pharmacy First service are also included in the plan, which will see, for the first time ever, patients who need prescription medication being able to get it directly from a pharmacy, without a GP appointment, for seven common conditions including earache, sore throat, or urinary tract infections. This is expected to free up around 15 million GP appointments over the next two years for patients who need them most.
Additionally, the plan helps to better support patients to manage their own health with up to half a million people a year self-referring for key services, including physiotherapy, hearing tests, and podiatry, without seeing their GP first.
Ending the 8am ‘rush’ for appointments will support practices in shifting from analogue to digital telephony, enabling GP teams to manage multiple calls and extra training will also be provided to staff answering calls, so that people who need to see their family doctor are prioritised while those who would be better seen by other staff such as physiotherapists or mental health specialists are able to bypass their GP.
Published alongside the delivery plan is the NHS England-commissioned Academy of Medical Royal Colleges (AoMRC) report into improving the primary – secondary care interface. Their report – General Practice and Secondary Care: Working Better Together – is a practical resource for Integrated Care Boards (ICBs) that sets out a series of recommendations and over 50 examples where local collaboration has helped reduce unnecessary workload in both clinical settings
A series of webinars are taking place to provide more information about the delivery plan, including next steps and details of how to access support and funding. Webinars that have already taken place have been recorded and can be watched here.
NHS England wrote to commissioners and GP practices outlining contractual arrangements for 2023/24, the final year of the five-year Investment and Evolution framework that was published in 2019. For 2023/24 the contract focuses on supporting teams and improving patient access and experience.
The delivery plan for recovering access to primary care committed to training 6,500 staff (one person from every practice in the country) in care navigation skills.
Practice and PCN managers can nominate one member of staff, ideally reception staff and care navigators involved in triaging requests, to complete virtual care navigation training. On completion, individuals will be confident to communicate effectively with patients and be able to signpost to the most relevant team member or local services depending on patient needs.
The new national primary care clinical pathway for constipation in children guidance supports clinicians in the prevention and management of constipation in children and young people by providing a clear and standardised approach, based on guidelines from the National Institute for Health and Care Excellence (NICE), the British National Formulary for Children (BNFc) and clinical expert groups. The pathway promotes available resources for clinicians, families and other care providers and ensures they are easily accessible, as well as raises the profile of constipation in children and young people with a learning disability as a factor in adult mortality rates.
As well as this, there are other resources available to watch or download, including short videos and a printable poster. This work was produced in collaboration with NHS England – South West, ERIC – The Children’s Bowel & Bladder Charity, Bladder & Bowel UK, Academic Health Science Network – South West and the National Network of Parent Carer Forums – South West.
You can read and download the latest information on identifying and supporting unpaid carers here.
The NHS is working to make it easier for patients to digitally access their future health information in their general practice records.
A letter has been sent to ICBs, Acute, mental health and community trusts, and to NHS England regional medical directors by Vin Diwakar, Medical Director for Secondary Care and Medical Director for Transformation and Dr Kiren Collison, Interim Medical Director for Primary Care. This letter is to provide an update on the automatic switch on of prospective access for patients, with guidance for staff when sending information into general practice.
Nearly one in four practices across the country have switched on automatic access to new health record information, benefitting over 7m patients who can now view tests results, appointment notes and hospital letters online instead of having to contact their surgery.
Remaining practices are being supported nationally and through local commissioners to switch on access for all their patients ahead of this date.
Further information is available for health and care professionals, including resources to help practices prepare for the change and guidance for other staff who send information into general practice.
Further information for patients on accessing their media records can be found on the NHS website.
We need to ensure that general practice has the support, technology and time to deliver the right care for patients in the right way and at the right time. Further information can be found in Our plan for improving access for patients and supporting general practice.
Resources are available for use in healthcare settings to encourage patients to treat NHS staff with respect by ‘social norming’ this behaviour. The pre-populated assets feature NHS staff working in NHS settings and carry the message ‘We are here to help you. Thank you for treating us with respect’.
General practice team
The general practice team has expanded to include a wide range of healthcare professionals who work alongside GPs and nurses to ensure patients receive the care they need as quickly as possible. Download resources here, including posters and digital screen graphics.
General practice access routes
Resources are available to help patients to better understand the choice of access route to use when contacting a GP practice. The campaign can also help GP practices better communicate with their patients about the best ways of getting in touch with them when they need help.
Community pharmacy consultation service
Referring suitable patients to a community pharmacist for a consultation under CPCS helps improve access to primary care services, supports patients to be treated by the right healthcare professional at the right time and improves the integration of community pharmacy into urgent care. Download supporting resources here.
We have suite of interlocking GP recruitment and retention initiatives available to help support and sustain the general practice workforce including:
- New to Partnership Payment Scheme
- General Practice Fellowship programme
- Supporting Mentors Scheme
- Primary care flexible staff pools
The GP Career Support Hub supports GPs during the different stages of their career.
Workforce planning and recruitment to the primary care workforce continues to be a key priority. The Additional Roles Reimbursement Scheme (ARRS) online portal provides a more effective and simple way for PCNs to claim, and CCGs to approve, reimbursement for the roles hired. Further information to support recruitment into these roles is available on FutureNHS.
Our confidential Looking After You coaching support is available for all primary care staff. The three services have been designed to be easily accessible and tailored to individual needs. Experienced coaches can help people with their wellbeing, reflect on career goals and ambitions, and support leaders to manage their teams.
There is a range of additional support offers in place to suit a range of different health and wellbeing needs, including:
- support lines and wellbeing apps
- our FutureNHS space has wellbeing support and advice for managing patients
- support for colleagues with Long Covid.
COVID-19 testing policy update published in March 2023 outlines changes to NHS use cases.
We have a dedicated space for the COVID-19 Vaccination Programme on our FutureNHS workspace, where you can access all the latest information on the vaccine programme. For all the latest information, check out our vaccine web pages.