Modern general practice model

What is the modern general practice model?

The Delivery plan for recovering access to primary care commits to supporting practices to move to a modern general practice model

This model is a way of organising work in general practice that enables practices to:

  • see all patient need, by providing inclusive, straightforward online and telephone access
  • understand all need through structured information gathering
  • prioritise and allocate need safely and equitably (including continuity of care)
  • make best use of other primary care services and the multi-professional team
  • improve the efficiency of their processes and reduce duplication.

Understanding demand and capacity

To establish a modern general practice model, it is essential for practices to have as complete a view as possible of all demand coming into the practice by all routes and to understand the nature and pattern of this demand, eg across different days of the week and at different times of year.

It is also important for practices to understand the capacity available in terms of staff time and skills. It is then possible to design and implement processes to match capacity to demand more effectively.

Improving the experience of telephoning the practice and using online access routes

The modern general practice model involves providing a smooth, equitable experience of access to patients across phone, online and walk-in routes.

Supporting practices to move to and optimise the capability of cloud-based telephony is essential to help provide a better experience for patients (eg so patients can be provided with queue position and callback options) and to enable practices to proactively manage peaks in demand through real time data monitoring and to support evidence-based service decisions.

Well-designed practice websites are also critical and need to give clear information on how to request help and what steps patients can take for themselves.

Online forms (provided via ‘online consultation tools’) should be available via the practice website and via tools like the NHS App to provide an easy route for patients to explain what they need and to request support.

Improvements to other tools and integration of digital services are also important to the model to allow increased self-service and more streamlined flows between different services.

Enhancing navigation and triage processes

The modern general practice model moves away from the 8am phone call queue and ‘first come, first served’ process for allocating appointments.

Instead, the model requires consistent structured information to be collected at the point of contact – to let the practice know about symptoms, ask a question, make a request or follow up about something – with patients either providing this information via an online form or to reception staff who capture the information about their needs.

Patient needs can then be consistently assessed and prioritised (triaged), allowing practices to provide patients with the most appropriate care or other response, from the right member of the practice team, including signposting or referring patients to other appropriate services.

The ability to better allocate patients to the right health professional or service supports effective use of all staff time and skills, including staff employed through the Additional Roles Reimbursement Scheme (ARRS).

It also supports improved ability and capacity to provide continuity of care for those that would benefit most, including vulnerable patients and those with long-term conditions.

The use of different consultation modalities, including text or online messages, is also important to facilitate flexible working for staff (which supports retention) and provides a variety of options for patients to receive care and advice in the most effective way depending on their needs.

Management of non-patient-facing practice workload

The modern general practice model gives practice staff better control over their workload with demand more consistently understood and managed, and the consistency of processes and workflows improved.

Alongside these changes, other improvements can also be made to streamline non-patient-facing processes in the practice, increase efficiency and reduce burden on staff.

This could also improve the trust that patients hold in practices as they will receive the care they need when they need it, from the person best suited to help them, preventing wasted visits and multiple calls to the surgery.

The General Practice Improvement Programme helps practices and PCNs to implement the modern general practice model by supporting change to be made and by providing tools, guidance and resources to make the change easier – building on what other practices have learnt and developed.

Where practices have innovated and created the different elements of the modern general practice model, these have been collated and codified and are being shared more widely, helping practices and PCNs make changes more easily and realise the benefits more quickly.