Source · Select Committees · Health and Social Care Committee
Fourth Report - The future of general practice
Health and Social Care Committee
HC 113
Published 20 October 2022
Recommendations
32
Accepted
Para 111
Need for Integrated Care Systems to simplify patient interface and improve first-contact access.
Recommendation
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 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.
Department of Health and Social Care
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40
Accepted
Increase organisational support for GPs focusing on crucial back-office functions like HR and data.
Recommendation
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 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.
Department of Health and Social Care
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Conclusions (9)
1
Conclusion
Accepted
Para 32
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 …
Government Response 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 access approach), recruitment of over 29,000 primary care professionals since 2019, and measures to reduce GP bureaucracy.
2
Conclusion
Accepted
Para 33
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 …
Government Response 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 'Bureaucracy busting concordat', and pilots for automating administrative processes.
4
Conclusion
Accepted
Para 38
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 …
Government Response 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 hard-to-recruit areas, with 800 places available in 2022.
7
Conclusion
Accepted
Para 46
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 …
Government Response 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. It also states that inner and outer London weightings are reflected within current ARRS allocations to PCNs.
11
Conclusion
Accepted
Para 57
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 …
Government Response 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.
20
Conclusion
Accepted
Para 73
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 …
Government Response 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.
21
Conclusion
Accepted
Para 79
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 …
Government Response 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.
31
Conclusion
Accepted
Para 110
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 …
Government Response 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.
39
Conclusion
Accepted
Para 128
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 …
Government Response 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.