Plan promises better GP access and reduced pressure

Delivery plan for recovering access to primary care aims to make it easier for patients to contact their GP and end the 08:00 rush, providing a commitment that patients will know how their request will be managed on the day of their call. It will also target a reduction in pressure on general practice.

The £1bn of ‘retargeted’ funds include:

• £240m in 2023/24 to support practices and primary care networks (PCNs) to improve access – including online tools, digital telephony, care navigation training and transformation support.
• Up to £645m over the next two years to expand community pharmacy services
• £246m of the streamlined investment and impact fund redirected towards improving access – 70% awarded unconditionally to PCNs, with the remainder awarded by integrated care boards once PCNs hit agreed access and experience targets.

The plan also said the government would continue to fund the target of recruiting 26,000 more direct care staff by March 2024 – making an extra £385m available in 2023/24 – and to allocate system development funding to ICBs. A  large part of the 2023/24 development pot of £170m is expected to be used for primary care transformation.

As part of the access improvements, practices with existing analogue phone systems will move to digital sytems. An average sized practice of 10,000 patients often receives more than 100 calls in the first hour every Monday. With advanced telephony, patients will be given a queue position and a call back option. Care navigators will also help assess, prioritise, respond and assist – directing patients to other professionals where appropriate

The expansion of pharmacy services is also expected to free up GP time. Expanding oral contraception and blood pressure services, together with enabling pharmacists to prescribe medicines for seven common conditions could save 10 million appointments a year, the plan claimed.

Health and social care secretary Steve Barclay said progress had already been made with 10% more GP appointments happening every month compared to before the pandemic. But more could be done. ‘I want to make sure people receive the right support when they contact their general practice and bring an end to the 8am scramble for appointments,’ he said. ‘To do this we are improving technology and reducing bureaucracy, increasing staffing and changing the way primary care services are provided, which are all helping to deliver on the government’s promise to cut waiting lists.’

Ruth Rankine (pictured), director of primary care at the NHS Confederation, said that PCN leaders would welcome any plans for additional investment – with digital telephony, care navigators and expanded pharmacy expansion all ‘desperately needed’. ‘However, primary care will only be able to fully recover and manage the increasing demand if there is sufficient investment and commitment from the government to increase the actual numbers of GPs, nurses and other vital posts in the NHS at a time when there are over 130,000 vacancies in England alongside record demand for healthcare,’ she said.  

‘If the government truly wants to “end the 8am scramble” rather than pay lip service to the public, its ambition will need to go further to retain the workforce we already have.’

And Nuffield Trust senior clinical fellow Rebecca Rosen warned that the staff time and resources needed to bring in the new systems should not be underestimated.  ‘Most practices will require a root and branch redesign and these often-small teams will require a lot of support to make these ambitions a reality,’ she said.  The real test for plan would be whether enough cover was provided from locum GPs and funded with new money.