Recommendations & Conclusions
18 items
3
Recommendation
Fourth Report - The future of general p…
Deferred
The Government should commission a review into short-term problems that constrain primary care including, but not limited to: the interface between primary and secondary care, prescribing from signing to dispensing, administrative tasks e.g. reports and sick notes, day-to-day usability of IT hardware and software, and reviewing of bloods, pathology and …
Government response. The government partially accepts the recommendation but shifts focus entirely from commissioning a review into short-term operational problems to discussing increases in GP speciality training places and changes to training duration (from 18 to 24 months in general practice).
Department of Health and Social Care
5
Recommendation
Fourth Report - The future of general p…
Deferred
The Government should provide the funding necessary to create 1,000 additional GP training places per year and consider extending the GP training scheme to four years, to allow GP trainees more time to develop their skills in practice as well as learn the skills required to enter a GP partnership.
Government response. The government partially accepts but redirects the focus from increasing GP training places and extending training duration to the Additional Roles Reimbursement Scheme (ARRS). It commits to increasing ARRS flexibility by adding new reimbursable roles, increasing caps on Advanced Practitioners, …
Department of Health and Social Care
6
Recommendation
Fourth Report - The future of general p…
Deferred
The Government and NHS England should identify mechanisms to distribute GP trainees more equitably across the country so that under-doctored areas receive a balanced proportion of domestic and international GP trainees. The Government should explore schemes that incentivise GP trainees to settle in the areas they train; this could come …
Government response. The government accepts the recommendation but deflects by addressing the role of receptionists and care navigation training instead of GP trainee distribution and incentives. It commits to investing in a new National Care Navigation Training programme for up to 6,500 …
Department of Health and Social Care
8
Recommendation
Fourth Report - The future of general p…
Deferred
NHS England should set out how it plans to increase the flexibility of the Additional Roles Reimbursement Scheme to allow Primary Care Networks to hire both clinical and non-clinical professionals other than those set out in the current guidance, according to local need.
Government response. The government partially accepts but deflects by focusing on e-prescribing in hospitals and the interface between general practice and hospitals. It rejects a national mandate for a standardised reporting tool, stating that Integrated Care Boards should decide their own approaches …
Department of Health and Social Care
9
Recommendation
Fourth Report - The future of general p…
Deferred
Receptionists play an incredibly important role in primary care that often goes unrecognised. Given they are often the first point of contact with primary care for most patients, NHS England should review and consider providing standardised national training to drive up standards and equip receptionists with the skills required to …
Government response. The government partially accepts the recommendation but deflects by focusing on exploring opportunities for automating processes in general practice to free up clinical capacity. It highlights ongoing support for two pilots testing automated coding of bowel screening results and other …
Department of Health and Social Care
10
Conclusion
Fourth Report - The future of general p…
Deferred
The Government and NHS England should explore the possibility of providing an uplift to the Additional Roles Reimbursement Scheme to support non-staff costs such as supervision and training or to provide weighted salaries in areas where the cost of living is high or it is hard to recruit. Consideration should …
Government response. The government's response discusses ongoing work and future plans for improving primary care IT systems, digital consultation tools, and cloud-based telephony, which bears no relation to the recommendation regarding Additional Roles Reimbursement Scheme (ARRS) uplift or Agenda for Change terms.
Department of Health and Social Care
13
Recommendation
Fourth Report - The future of general p…
Deferred
The Government should also fund research into the specific role that machine learning can play in the automation of reporting and coding test results to reduce clinical admin in general practice.
Government response. The government's response outlines changes to pension arrangements, including increasing the annual allowance, abolishing the lifetime allowance, and introducing retirement flexibilities, which is entirely unrelated to the recommendation about funding machine learning research for admin reduction.
Department of Health and Social Care
14
Recommendation
Fourth Report - The future of general p…
Deferred
The Government should undertake a full review of primary care IT systems from the perspective of the clinicians with an emphasis on improving the end user interface. Making the working life of each clinician that bit easier will drastically improve morale and efficiency.
Government response. The government's response discusses the importance of continuity of care, the named GP policy, the Fuller Stocktake, and the role of multi-disciplinary teams, which bears no relation to the recommendation for a review of primary care IT systems.
Department of Health and Social Care
15
Conclusion
Fourth Report - The future of general p…
Deferred
As we said in our recent Report on the NHS workforce, no NHS employee should be forced to choose to locum or work for an agency to regain control over their working The future of general practice 41 life. This is equally true in NHS general practice. As well as …
Government response. The government partially accepts, stating they will introduce methods to promote continuity of care and consider how best to measure it, but will not commit to a specific measure by 2024, which is unrelated to the committee's recommendation on locum …
Department of Health and Social Care
18
Conclusion
Fourth Report - The future of general p…
Deferred
Older GPs continue to face prohibitively expensive pensions tax bills which act as a significant disincentive to them staying in practice. Efforts taken to date to reduce the impact on GPs have not been sufficient to prevent experienced GPs from leaving the profession in significant numbers, however we note the …
Government response. The government rejects the recommendation, stating that it does not accept it because the size and skills mix of the workforce are matters for individual general practices to determine, which is unrelated to the recommendation on GP pension tax bills.
Department of Health and Social Care
19
Recommendation
Fourth Report - The future of general p…
Deferred
The Government and NHS England should adopt the recommendations related to NHS pensions in our recent Report on Workforce: recruitment, training and retention in health and social care. In developing short and long-term solutions to the NHS pensions issue the Government and NHS England must specifically account for the status …
Government response. The government rejects the recommendation by referring to its response to recommendation 17 (which concerned continuity of care models) and reiterates plans to promote the RCGP’s Continuity of Care toolkit, thereby failing to address the substance of NHS pensions for …
Department of Health and Social Care
23
Conclusion
Fourth Report - The future of general p…
Deferred
The Government and NHS England must acknowledge the decline in continuity of care in recent years and make it an explicit national priority to reverse this decline.
Government response. The government partially accepts the recommendation but discusses current and ongoing work to explore gain sharing agreements and financial incentives to reward primary care for reducing secondary care expenditure, rather than making continuity of care an explicit national priority.
Department of Health and Social Care
24
Conclusion
Fourth Report - The future of general p…
Deferred
Unless continuity of care is routinely measured GP practices and Primary Care Networks will be unable to identify where to focus improvement efforts. NHS England will also be unable to effectively target support without establishing a baseline for the provision of continuity of care. Measuring the proportion of appointments delivered …
Government response. The government partially accepts but deflects the recommendation, discussing existing funding mechanisms like the Carr-Hill formula, which it states will not be changed until the end of 2023/24, instead of addressing the routine measurement of continuity of care.
Department of Health and Social Care
25
Conclusion
Fourth Report - The future of general p…
Deferred
NHS England should introduce a national measure of continuity of care to be reported by all GP practices by 2024. The new measure should be based on existing models such as the Usual Provider Continuity Index and the St Leonard’s Index of Continuity of Care and in the short term …
Government response. The government accepts the recommendation but discusses existing and upcoming organisational support initiatives for Primary Care Networks and practices, including digital tools, care navigation training, and the National General Practice Improvement Programme, rather than committing to a national measure of …
Department of Health and Social Care
26
Conclusion
Fourth Report - The future of general p…
Deferred
NHS England should provide Primary Care Networks with additional funding to appoint a ‘continuity lead’ for at least one session per week, and additional admin staff funding to support the lead in the role. The role of the continuity lead GP would be to support practices within their network to …
Government response. The government partially accepts the recommendation but discusses its commitment to the partnership model and existing investments in general practice funding through various schemes, without addressing the specific request for additional funding for PCN 'continuity leads'.
Department of Health and Social Care
27
Conclusion
Fourth Report - The future of general p…
Deferred
Personal lists are the best way to deliver continuity of care and are therefore an essential component of improving the levels of continuity provided in NHS general practice. We recognise the pressures in general practice but we believe that delivering high levels of continuity will reduce pressure on GPs rather …
Government response. The government partially accepts but deflects the recommendation, discussing challenges related to GP premises, property ownership, and how primary care infrastructure can be supported through the planning system, including updating relevant guidance.
Department of Health and Social Care
28
Conclusion
Fourth Report - The future of general p…
Deferred
As part of wider efforts to improve continuity of care NHS England should champion the personal list model rather than dismissing it as unachievable. NHS England should set a stretching ambition that by 2027 80% of practices have returned to personal list continuity and provide support for practices to do …
Government response. The government partially accepts but deflects the recommendation, stating it needs further exploration before committing to accelerate plans to allow GP partners to operate as Limited Liability Partnerships (LLPs), citing concerns about legal and financial risks and low take-up in …
Department of Health and Social Care
45
Recommendation
Fourth Report - The future of general p…
Deferred
The Government should accelerate plans to allow GP partners to operate as Limited Liability Partnerships or other similar models which limit the amount of risk to which GP partners are exposed. (Paragraph 144) 46 The future of general practice
Government response. The government partially accepts but defers action, stating further exploration is needed regarding the impact on NHS England and government before committing to accelerate plans for Limited Liability Partnerships.
Department of Health and Social Care