Recommendation 28

HM Government · verbatim extract Deferred

Do not accept. The Department does not accept this recommendation. We agree that continuity of care is important within general practice but do not agree that requiring a return to the personal list model is the correct approach. Prior to 2004, patients were registered with individual general practitioners who each held a contract to provide services to their registered patients. In 2004, the practice-based contractual model was introduced, which has enabled practices (for example partnerships) to hold GP contracts. The practice-based contractual model was introduced in 2004 to give practices more flexibility to deploy their workforce to meet their patients’ needs, to allow practices to leverage the benefits of working at scale (including increased resilience – for example, should a GP take long-term leave), and to enable more non-GP professionals to be partners. In addition, through the introduction of Primary Care Networks and the Additional Roles Reimbursement Scheme, we are supporting general practice teams to deliver a wider range of services to patients, by providing them with resources to expand and diversify their workforce and build multidisciplinary teams. It is vital that we protect those benefits and make best use of the growing range of skills in our general practice teams, alongside delivering continuity of care to those patients who need it. Since 2015/16 (and since 2014/15 for patients aged 75 and over) practices have been required to assign all patients a ‘named GP’ who is accountable for the care of each patient they are assigned to. Practices must take reasonable efforts to accommodate patients’ requests to be assigned a particular accountable GP and must endeavour to grant all reasonable requests of patients to see a particular practitioner for their appointment, including their ‘named’ GP. Patients may however need to wait longer to see a particular GP (for example, if that GP is on leave). Within this context, it is for practices to determine the best way to meet the needs of their patients. There are no contractual barriers to practices operating a system where the contract remains practice-based, but within a practice, each GP is assigned a list of patients who they are responsible for and conduct appointments with. However, to ensure the ‘named GP’ policy is delivering on improving continuity of care we are further embedding continuity via the 2023/24 GP contract by promoting the use of the Royal College of GP’s Continuity of Care toolkit via the Quality and Outcomes Framework Quality Improvement module on Optimising Demand and Capacity management in general practice.