Next steps on delivering the Delivery plan for recovering access to primary care: letter


  • Integrated care boards:
    • chief executive officers
    • chairs
    • medical directors
    • chief operating officers
    • digital directors
    • directors of communications and engagement


  • NHS England regional directors
  • NHS England regional directors of commissioning
  • NHS England regional directors of primary care
  • Regional heads of primary care

Dear Colleagues,

Next steps on delivering the Delivery plan for recovering access to primary care

Following publication of the Delivery plan for recovering access to primary care in May, I would like to thank integrated care boards (ICBs), primary care networks (PCNs) and practices for their hard work to achieve the initial actions set out in the published checklist and provide an update on next steps.

Thanks to your efforts, 100% of practices still on analogue telephone lines have signed up to move to cloud based digital telephony, which is a significant achievement. To date, funding of circa £39 million has flowed to ICBs to enable new telephone systems to be purchased, supporting our drive to ensure patients can contact their practice more easily.

We’ve also seen over 4,000 practice and PCN staff register for our new, free care navigation training and have exceeded the commitment to recruit 26,000 more direct patient care professionals in general practice through the Additional Roles Reimbursement Scheme a year early, with more than 29,000 recruited at 31 March 2023.

The autumn sees some key next delivery steps. In line with feedback from regional, system and workstream colleagues, the checklist of actions accompanying the delivery plan has been updated. Some actions have been clarified or expanded and some deadlines have been amended.

Regions and ICBs are asked to become familiar with the updated checklist and associated timelines to enable all ICBs to produce system level access improvement plans which need to go ICB public boards in October or November 2023. These ICB access improvement plans also need to include a summary of practice/PCN improvement plans, challenges, wider support needs and barriers and ICB actions based on the briefing note published on 31 July 2023.

Some primary delivery areas with associated actions to be included in these ICB plans are set out below:

  1. Cloud-based telephony – Support 1,000 practices to transition to digital telephony by December 2023, all remaining analogue practices to move to digital telephony by March 2024. We expect ICBs to be actively monitoring progress, working alongside the national procurement hub. We will also support ICBs to review the quality of cloud-based telephony already in place over the Autumn with a view to improve this where necessary.
  2. NHS App – ICBs encourage and support remaining practices to leverage the core functions of the NHS App, to empower patients and enable them to self-serve where appropriate. ICBs should be assured that each practice has a plan for each patient to receive prospective record access (unless exceptions apply) from 31 October. Where practices do not have a plan, ICBs will understand why and what action and support is needed to ensure compliance with the regulations.
  3. Digital pathways framework – Engagement with market continues and the timeline for the launch of the framework has been updated. Regions and ICBs are urged to review the updated checklist of actions. During September and October, in advance of the winter period, we are asking that ICBs work with their practices to fully understand the contracting position for their online consultation, messaging and booking solutions currently in use. Over the autumn there will be focus on helping ensure ICBs and practices are ready for the new framework.  We will be working with regional teams to issue guidance and information on what to expect from the framework to ensure that ICBs are updated on developments and can begin preparatory work. Alongside this we are asking ICBs and practices to maximise use of digital tools already available to practices that support patient access this winter.
  4. National General Practice Improvement Programme – This free programme, with some associated funding, supports practices and PCN teams to implement the modern general practice model of access using the digital tools and training we are providing. Regions and ICBs are urged to continue to encourage their practices and PCN teams to participate in the programme and nominations should continue to be made.
  5. Improving the primary-secondary care interface – We expect each ICB to have an executive lead in place to support interface improvements across primary and secondary care providers.
  6. Self-referral pathways – ICBs are asked to expand self-referral pathways (login required) by the end of September 2023 in seven named service areas, as set out in operational planning guidance published in December 2022 and reaffirmed in the recovery plan. This commitment remains unchanged. Work is ongoing to support ICBs who need help to expand some pathways.

Please note we are investing significant funding to support the Primary care access recovery plan. ICBs should be assured that primary care recovery funding is being used for its intended purpose. It should be used as additional support for primary care, with other primary care funding, remaining in place and not being reduced, for example, GP IT.

Please ensure this letter is shared with your PCNs and practices and continue to work closely with your regional team to encourage them to take up all the available support offers.

NHS England has been hosting a series of explainer webinars about the plan and the support offers, with past recordings and upcoming dates of future webinars available on FutureNHS (login required). You can also join our primary care access recovery workspace (login required) to collaborate, share best practice and get the latest information

As always, thank you for your ongoing hard work and commitment to providing high-quality care.

Yours sincerely,

Dr Amanda Doyle OBE MRCGP

National Director, Primary Care and Community Services

NHS England

Publication reference: PRN00720_i