Recommendations & Conclusions
11 items
1
Conclusion
Fourth Report - The future of general p…
Accepted
The first step to solving a problem is to acknowledge it and we believe that general practice is in crisis. It is clear from the latest GP Patient survey results that despite the best efforts of GPs, the elastic has snapped after many years of pressure. Patients are facing unacceptably …
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The first step to solving a problem is to acknowledge it and we believe that general practice is in crisis. It is clear from the latest GP Patient survey results that despite the best efforts of GPs, the elastic has snapped after many years of pressure. Patients are facing unacceptably poor access to, and experiences of, general practice and patient safety is at risk from unsustainable pressures. Patient access is at the heart of NHS general practice and we are very concerned about this decline in standards. Given their reluctance to acknowledge the crisis in general practice we are not convinced that the Government or NHS England are prepared to address the problems in the service with sufficient urgency. The Government’s Plan for Patients places a welcome emphasis on improving access to general practice but the measures set out so far will not be sufficient to make a meaningful difference to patient access and do not deal sufficiently with how to improve outcomes.
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Government response AI summary
The government partially accepts, acknowledging access challenges but not a 'crisis'. It details ongoing efforts and specific actions from its Delivery Plan for Recovering Access to Primary Care, including a retargeted investment of over £1bn (up to £645m in community pharmacy, £240m for a new …
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Department of Health and Social Care
2
Conclusion
Fourth Report - The future of general p…
Accepted
In response to this Report the Government and NHS England should be clear in acknowledging that there is a crisis in general practice and set out in more detail the steps they are taking in response to this crisis in the short term, to protect patient safety, strengthen continuity, improve …
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In response to this Report the Government and NHS England should be clear in acknowledging that there is a crisis in general practice and set out in more detail the steps they are taking in response to this crisis in the short term, to protect patient safety, strengthen continuity, improve access and reduce GP workloads.
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Government response AI summary
The government partially accepts, agreeing to explore solutions for primary care constraints but states it does not want to duplicate ongoing work. It points to existing efforts like the Academy of Medical Royal Colleges review, the Delivery Plan for Recovering Access to Primary Care, the …
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Department of Health and Social Care
4
Conclusion
Fourth Report - The future of general p…
Accepted
GP recruitment is essential to resolving the crisis in general practice, and while it is disappointing that the Government remains off track to meet its target to recruit 6,000 additional GPs by 2024, the growth in the number of GP trainees over recent years is encouraging. Nonetheless, there are further …
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GP recruitment is essential to resolving the crisis in general practice, and while it is disappointing that the Government remains off track to meet its target to recruit 6,000 additional GPs by 2024, the growth in the number of GP trainees over recent years is encouraging. Nonetheless, there are further steps the Government can take both to increase GP recruitment and improve the outcomes of GP training.
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Government response AI summary
The government accepts and is adapting GP specialty training distribution to better reflect population needs as part of NHS England’s trainee redistribution programme. It also highlights ongoing efforts like new medical schools and the Targeted Enhanced Recruitment Scheme, which provided £20,000 incentives for training in …
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Department of Health and Social Care
7
Conclusion
Fourth Report - The future of general p…
Accepted
We welcome the progress made in recruiting additional professionals to general practice and recognise the potential they have to improve the range of services on offer in general practice and to ensure patients are able to see the right professional at the right time. We are also pleased the Government …
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We welcome the progress made in recruiting additional professionals to general practice and recognise the potential they have to improve the range of services on offer in general practice and to ensure patients are able to see the right professional at the right time. We are also pleased the Government has committed to increasing the flexibility of staff recruited under the Additional Roles Reimbursement Scheme. However, we are concerned about some gaps within the scheme, particularly the lack of funding for supervision and the absence of any uplift for areas of high need. At present it appears that some staff are not regularly being effectively integrated into general practice and do not receive adequate supervision.
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Government response AI summary
The government partially accepts, acknowledging that ARRS doesn't explicitly cover supervision for all roles but states support creates supervisory capacity for Advanced Practitioners. It commits to reimbursing Primary Care Networks (PCNs) for First Contact Practitioners' training time and has increased the cap on Advanced Practitioners. …
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Department of Health and Social Care
11
Conclusion
Fourth Report - The future of general p…
Accepted
The Government and NHS England have made a start on reducing the administrative workload in general practice, and it is also encouraging to see some Integrated Care Systems agreeing to try to reduce the amount of work that is inappropriately transferred from secondary care to primary care. However, it is …
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The Government and NHS England have made a start on reducing the administrative workload in general practice, and it is also encouraging to see some Integrated Care Systems agreeing to try to reduce the amount of work that is inappropriately transferred from secondary care to primary care. However, it is clear that there is still a long way to go to make GP workloads more sustainable.
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Government response AI summary
The government partially accepts, focusing on existing GP retention schemes (National GP Retention Scheme, Fellowship Programme) and exploring flexible working to support retention, while noting that GP partnerships are responsible for reviewing working conditions.
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Department of Health and Social Care
20
Conclusion
Fourth Report - The future of general p…
Accepted
We are extremely concerned about declining provision of continuity of care in general practice. We recognise the enormous pressure that GP services are under but it is unacceptable that one of the defining standards of general practice has been allowed to erode in this way. While we recognise the importance …
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We are extremely concerned about declining provision of continuity of care in general practice. We recognise the enormous pressure that GP services are under but it is unacceptable that one of the defining standards of general practice has been allowed to erode in this way. While we recognise the importance of continuity of information and accountability, and the important role that other professionals can play in providing continuity, we believe the ongoing relationship between a GP and their patients is uniquely important. The Government and NHS leaders have not paid sufficient attention to continuity of care or prioritised it effectively in national policy, which has hastened its decline.
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Government response AI summary
The government accepts the recommendation and states that continuity of care is a priority for Integrated Care Systems, citing existing initiatives like the Modern General Practice Access approach, issued frameworks, and ongoing work to improve digital services and patient communication.
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Department of Health and Social Care
21
Conclusion
Fourth Report - The future of general p…
Accepted
We believe that continuity of care is one of the most important goals for NHS general practice. There is a wealth of evidence that higher levels of continuity of care in general practice are better for both patients and GPs themselves. Continuity of care is more efficient for GPs, improves …
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We believe that continuity of care is one of the most important goals for NHS general practice. There is a wealth of evidence that higher levels of continuity of care in general practice are better for both patients and GPs themselves. Continuity of care is more efficient for GPs, improves their shared decision making with patients, and provides them with greater professional satisfaction and development. More importantly, it improves patients’ experience of their care and leads to significantly improved outcomes including reduced hospital and A&E attendances. And rather than being impossible given current pressures there is also evidence to suggest 42 The future of general practice that high continuity is also a more efficient use of resources. One way to improve continuity would be to cap individual GP list sizes, which we believe is a pragmatic solution that should be explored as outlined later in this report.
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Government response AI summary
The government partially accepts the recommendation, stating it will reduce QOF and IIF indicators for 2023/24 to address micro-incentives. It also commits to formally consulting on the future of QOF during 2023/24 and engaging with stakeholders on IIF reform.
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Department of Health and Social Care
31
Conclusion
Fourth Report - The future of general p…
Accepted
Primary Care Networks and Integrated Care Systems offer an opportunity to better integrate care around people. It should not be the case that patients face so much uncertainty about where to turn to if they have a new or urgent care need and it is particularly unacceptable if the number …
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Primary Care Networks and Integrated Care Systems offer an opportunity to better integrate care around people. It should not be the case that patients face so much uncertainty about where to turn to if they have a new or urgent care need and it is particularly unacceptable if the number of different organisations involved in providing first-contact services to patients makes it harder to patients to access the care they need. It is welcome that Dr Claire Fuller’s review for NHS England has made this a priority.
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Government response AI summary
The government accepts the recommendation for better integrated care, stating NHS England has issued a framework to support access, implemented the Modern General Practice Access approach, begun commercial work to rationalise digital services, and started standardising patient communications.
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Department of Health and Social Care
32
Recommendation
Fourth Report - The future of general p…
Accepted
Integrated Care Systems should prioritise simplifying the patient interface with the NHS by improving access, triage and referral across first-contact NHS organisations including general practice.
Government response AI summary
The government accepts, stating it is a priority for ICSs and outlining initiatives like the Modern General Practice Access approach to improve patient navigation, triage, and access, alongside work on digital services and communication standardization.
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Department of Health and Social Care
39
Conclusion
Fourth Report - The future of general p…
Accepted
With general practice currently in crisis it is important that GPs are given the headspace that they need to work differently and improve services, or the potential advantages of new Primary Care Networks will not be realised. Giving GPs time to focus on improvement projects is an important component of …
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With general practice currently in crisis it is important that GPs are given the headspace that they need to work differently and improve services, or the potential advantages of new Primary Care Networks will not be realised. Giving GPs time to focus on improvement projects is an important component of this, but so too are important back-office functions like HR support and data analytics.
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Government response AI summary
The government accepts the importance of giving GPs headspace and back-office support, detailing plans for Integrated Care Systems to implement Fuller stocktake recommendations, providing digital tools and funding through a new delivery plan, and launching a National General Practice Improvement Programme.
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Department of Health and Social Care
40
Recommendation
Fourth Report - The future of general p…
Accepted
The Government and NHS England should increase the level of organisational support provided to GPs with a particular focus on important back-office functions such as HR, data and estates management. (Paragraph 129) The GP partnership
Government response AI summary
The government accepts and outlines several initiatives, including ICS implementation of Fuller stocktake recommendations, digital tools, care navigation training, and the new National General Practice Improvement Programme, to increase organisational support for GPs.
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Department of Health and Social Care