Select Committee · Health and Social Care Committee

The future of General Practice

Status: Closed Opened: 16 Nov 2021 Closed: 24 Jul 2023 20 recommendations 25 conclusions 1 report

The Committee has launched a new inquiry to explore the future of NHS general practice, examining the key challenges facing general practice over the next five years as well as the biggest current and ongoing barriers to access to general practice. General practice has seen significant changes in recent years, such as the development of … Show more

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Reports

1 report
Title HC No. Published Items Response
Fourth Report - The future of general practice HC 113 20 Oct 2022 45 Responded

Recommendations & Conclusions

7 items
33 Recommendation Fourth Report - The future of general p… Accepted in Part

Current general practice targets and incentives are overly bureaucratic, failing to improve outcomes.

Accountability and quality improvement are both extremely important in the NHS but it is clear that the current system of targets and incentives in general practice is overly bureaucratic, is not having the desired effect on outcomes, and will not enable GPs to change the way care is delivered. In … Read more

Government response AI summary
The government partially accepts, committing to a 25% reduction in QOF indicators and a reduction of IIF indicators from 36 to 5 for 2023/24. It will formally consult on the future of QOF and engage on IIF reform during 2023/24.
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Department of Health and Social Care
34 Recommendation Fourth Report - The future of general p… Accepted in Part

Imperative for NHS England to abolish QOF/IIF, reinvesting funds into core contract.

NHS England should abolish the Quality and Outcomes Framework and Impact and Investment Framework and re-invest the funding in the core contract, weighted to account for patient demographics including deprivation, to incentivise continuity of care.

Government response AI summary
The government partially accepts, stating that for 2023/24 there will be a 25% reduction in QOF indicators and the IIF will be reduced from 36 to 5. It will formally consult on the future of QOF during 2023/24 and engage with stakeholders on IIF reform.
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Department of Health and Social Care
35 Recommendation Fourth Report - The future of general p… Accepted in Part

Need for NHS England to improve GP outcomes data, focusing on key measures.

In particular, NHS England should focus on significantly improving the outcomes data provided to GPs by focusing data collection and analytical resource on outcomes measures rather than the process data and reporting required by these micro- incentives. Read more

Government response AI summary
The government partially accepts, committing to explore ways to strengthen outcomes data collection and monitoring during a 2023/24 consultation on the Quality and Outcomes Framework, while also stating the importance of process data.
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Department of Health and Social Care
36 Recommendation Fourth Report - The future of general p… Accepted in Part

NHS England's role supporting ICSs to implement gain sharing for reduced secondary care.

NHS England should support Integrated Care Systems to implement gain sharing so that Primary Care Networks and individual practices that support the reduction of secondary care expenditure, such as through reducing unplanned admissions, are able to share in the financial gains. Read more

Government response AI summary
The government partially accepts, committing to provide "light touch support" like sharing case studies for gain sharing, but notes difficulties in proving causality for direct financial transfers. They also state work is ongoing to explore additional opportunities to reward primary care.
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Department of Health and Social Care
42 Recommendation Fourth Report - The future of general p… Accepted in Part

Reaffirm Government commitment to GP partnership model and detail support for its future.

In response to this Report the Government should reaffirm its commitment to maintaining the GP partnership model and explain how it will take forward our recommendations to better support the partnership model, alongside ongoing work to enable other models of primary care provision. (Paragraph 135) The future of general practice … Read more

Government response AI summary
The government partially accepts the recommendation, reaffirming no policy to abolish the GP partnership model and highlighting existing investments to support general practice, while also expressing a desire to support a range of primary care provision models.
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Department of Health and Social Care
43 Conclusion Fourth Report - The future of general p… Accepted in Part

GP premises remain a significant burden, hindering retention and undermining patient care.

Despite the risk associated with GP premises continuing to be a significant burden on existing GP partners and a barrier to entry for potential new partners, little progress appears to have been made on this issue. Until the Government grips this issue properly it will continue to seriously undermine GP … Read more

Government response AI summary
The government partially accepts, agreeing to undertake analysis of the GP estate and consider alternative models. They will also update planning guidance to ensure primary care infrastructure is referenced and considered in new developments.
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Department of Health and Social Care
44 Recommendation Fourth Report - The future of general p… Accepted in Part

Consider adopting Scottish GP premises model and increase investment in general practice estate.

The Government should consider adopting the approach to GP premises taken in Scotland and conduct its own analysis of whether this would be viable for general practice in England. More widely the Government must make additional investment available for the general practice estate to enable integrated care to be effectively … Read more

Government response AI summary
The government partially accepts, declining to adopt the Scottish approach due to stakeholder views, but commits to undertaking analysis of the GP estate and considering alternative models. They will also update planning guidance to support primary care infrastructure in new developments.
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Department of Health and Social Care

Oral evidence sessions

4 sessions
Date Witnesses
12 Jul 2022 Dr Amanda Doyle · NHS England, Dr Nikki Kanani · NHS England, James Morris MP · Department of Health and Social Care, Matthew Style · Department of Health and Social Care View ↗
14 Jun 2022 Beccy Baird · King's Fund, Dr Margaret Ikpoh · Royal College of General Practitioners, Dr Peter Holden · Imperial Road Surgery, Mrs Heather Randle · Royal College of Nursing, Professor Mike Holmes · Haxby Group, Sir Robert Francis QC · HealthWatch England View ↗
18 May 2022 Dr Jacob Lee · Horfield Health Centre, Dr Kate Sidaway-Lee · St Leonard's Medical Practice, Dr Pauline Grant · Cheviot Road Surgery, Dr Rebecca Rosen · Nuffield Trust, Professor Steinar Hunskår · University of Bergen View ↗
15 Mar 2022 Dr Andrew Green, Retired GP, Dr Becks Fisher · The Health Foundation, Dr Kate Fallon · Somerton House Surgery, Dr Kieran Sharrock · British Medical Association (BMA), Professor Martin Marshall · Royal College of General Practitioners View ↗

Who gave evidence

20 witnesses
WitnessOrganisationSessions
Beccy Baird · Senior Fellow King's Fund 1
Dr Amanda Doyle · National Director for Primary Care and Community … NHS England 1
Dr Andrew Green, Retired GP 1
Dr Becks Fisher · Senior Policy Fellow The Health Foundation 1
Dr Jacob Lee · General Practitioner Horfield Health Centre 1
Dr Kate Fallon · GP Partner Somerton House Surgery 1
Dr Kate Sidaway-Lee · Research Fellow St Leonard's Medical Practice 1
Dr Kieran Sharrock · General Practitioners Committee (England) British Medical Association (BMA) 1
Dr Margaret Ikpoh · Vice Chair Professional Development Royal College of General Practitioners 1
Dr Nikki Kanani · Director of Clinical Integration and Deputy SRO o… NHS England 1
Dr Pauline Grant · General Practitioner Cheviot Road Surgery 1
Dr Peter Holden · GP Partner Imperial Road Surgery 1
Dr Rebecca Rosen · Senior Fellow Nuffield Trust 1
James Morris MP · Parliamentary Under-Secretary and Minister for Pa… Department of Health and Social Care 1
Matthew Style · Director General for Secondary Care and Integrati… Department of Health and Social Care 1
Mrs Heather Randle · Professional Lead for Education and Primary Care Royal College of Nursing 1
Professor Martin Marshall · Chair Royal College of General Practitioners 1
Professor Mike Holmes · GP Partner Haxby Group 1
Professor Steinar Hunskår · Professor of Primary Care University of Bergen 1
Sir Robert Francis QC · Chair HealthWatch England 1

Correspondence

2 letters
DateDirectionTitle
11 Jan 2023 To cttee Letter from the Parliamentary Under Secretary of State for Primary Care and Pub…
6 Sep 2022 Correspondence from the Parliamentary Under Secretary of State for Primary Care…