NHS England’s ‘Delivery plan for recovering access to primary care, was unveiled on 9 May 2023, with two central ambitions:
- Tackle the 8am rush and reduce the number of people struggling to contact their practice.
- For patients to know on the day they contact their practice how their request will be managed.
The plan focuses on addressing the well-known challenges of access to primary care. This is seen as a prerequisite first step ahead of longer-term reforms that will deliver the vision set out in the Fuller Stocktake for the future of primary care.
GPs should be aware of the plan’s key points about how primary care practice will evolve in the next two years. Note that funding and transitional support is available for practices that sign up to implement changes by the relevant deadlines in 2023/24, as indicated below.
Roll-out of ‘Modern General Practice Access’
By the end of 2023, it is hoped that most practices will have adopted the ‘Modern General Practice Access’ approach, using online tools, digital telephony, and triage by trained care navigators to make it easier for patients to contact the practice and learn how their request will be handled. It will also make it easier for practices to receive, navigate, assess, and respond to requests.
The plans are aligned with NHS contract changes for 2023/24, requiring patients to be offered ‘an assessment of need, or signposted to an appropriate service, at first contact with the practice’ from May 2023.
In Modern General Practice Access, patients should be told how their request will be managed on the day they first contact the practice:
- Clinically urgent: same day assessment by telephone or face-to-face appointment (next-day assessment is allowed where clinically appropriate if the patient contacts the practice in the afternoon).
- Non-urgent: telephone or face-to-face appointments scheduled within two weeks.
- Where appropriate, patients will be signposted to self-care or other local services such as community pharmacy or self-referral services.
Dates to be aware of:
- From May 2023, training and transformation support will be available through a National General Practice Improvement Programme.
- Practices on analogue phone systems that commit by 1 July 2023 to adopt digital telephony will receive support and funding up to about £60,000 over two years.
- Funding will be available for practices that sign up by March 2025 to adopt digital tools and care navigation training.
- All analogue phone systems across the country will be switched off by December 2025.
A major communications campaign will explain to patients how primary care is evolving and how they can best use the NHS. The hope is that many patients will find it more convenient to make requests and receive responses online, freeing up phones for those who prefer to call.
Empowering patients, relieving pressure on GPs
The plan also aims to employ tools that people can use to manage their own care, to relieve pressure on GP practice teams. Self-referral pathways will be expanded by September 2023, and by March 2024, it is expected that >90% of practices will enable patients to use the NHS App to see their health records, read practice messages, book appointments and order repeat prescriptions.
Subject to consultation, the Department of Health and Social Care (DHSC) will also expand the role of community pharmacies in 2023, potentially saving 10 million GP appointments each year by:
- Increasing provision of oral contraception and blood pressure services.
- Launching the Pharmacy First programme, allowing pharmacies to supply prescription-only medicines for sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women.
Increasing capacity and reducing bureaucracy
Within the plan is a commitment to publish the long-awaited NHS Long Term Workforce Plan, which will detail future GP training, recruitment, and retention plans. In the meantime, the plan intends to deliver more appointments with extra staff, with measures including:
- Larger multidisciplinary teams: increasing additional roles reimbursement (ARRS) funding and flexibility, to deliver on the commitment to fund more direct patient care staff.
- More new doctors: expanding GP specialty training; helping newly qualified GPs who require a visa to remain in England.
- Retention and return of experienced GPs: through pension reforms, and simplifying return to practice.
- Requiring higher priority for primary care in housing developments.
The plan also details how administrative workload in primary care will be eased, building on the Bureaucracy Busting Concordat published in 2022, by:
- Improving the interface between hospitals and primary care, including a reduction in inappropriate transfer of hospital administrative workload.
- Increasing self-certification to reduce medical evidence requests to GPs.
- Streamlining the Investment and Impact Fund and consulting on the Quality and Outcomes Framework clinical indicators.
Although the plans have been broadly welcomed, GP leaders in the British Medical Association and Royal College of General Practice remain concerned that more investment and support is crucial to deal with workforce and infrastructure problems, if the measures are to be implemented effectively. It remains to be seen how future long-term plans for reform will address these issues.
If you have questions or concerns about the NHS plans and how they will affect your practice, please contact us for advice at Medical Defense Society