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October saw the publication of the ‘House of Commons Health and Social Care Committee’ report on ‘The future of general practice’. Have you read it? If you’re leading or managing in primary care, you probably should.
Broadly speaking, it’s a positive and welcome report, recognising many of the issues being faced and making some sensible suggestions to address them. Other recommendations are more open to argument, with barriers easier to identify, but even so they’re not without merit. Time will tell, but along with the ‘Fuller Stocktake Report’ it may prove to be a significant document for general practice.
The report and its recommendations fall into 4 categories:
Access to general practice
Continuity of care
General practice and new NHS models
GP Partnership model
In each there are several recommendations of actions that should be taken. So what happens now?
We think it’s very likely that many of the recommendations will be taken forward. Primary care needs action, but as with many things in the NHS, much needed change can take time, often far too much time. But primary care has a choice, more than it realises, it doesn’t have to wait to start implementing some of the suggestions.
For us there are some standout recommendations that you can start work on:
Increase Additional Roles Reimbursement Scheme (ARRS) flexibility, allowing PCNs to hire they professionals they choose, based on local need.
ARRS roles have been a great thing bringing new roles into primary care, and there is nothing stopping practices bringing in additional skills if they see they’re needed. The bulk of staff aren’t funded through ARRS, and primary care shouldn’t think that all new roles have to come through this.
Provide standardised national training for receptionists.
This is one we definitely wouldn’t wait for and believe that locally developed and delivered training should be better, more focused and relevant than a national program.
Reduce the administrative workload through focusing on the primary-secondary care interface, introducing e- prescribing in hospitals and encouraging integrated care systems (ICSs) to provide a reporting tool for GPs to report inappropriate workload transfer.
Primary Care needs a voice within the ICS. If that doesn’t already exist, you don’t need to wait to develop that and the channels where you can be proactive in using it. You should regularly engage with colleagues in secondary care and the ICS, to manage the workload coming to practices and to report anything inappropriate.
Continuity leads should be funded at PCN level.
Introduce a national measure of continuity of care, based on the St Leonard’s Index, that all GP practices should report on by 2024. It should be reported quarterly at practice, PCN, ICS and national levels.
If you are agreed that continuity of care is a good thing and improving it will deliver benefits for patients and workforce, then there is nothing to stop a PCN appointing a Continuity Lead ahead of funding. The reason for doing so should be the benefits you gain, not the funding. If it’s a good thing, then don’t wait to start working and reporting on this area to realise the benefits at practice level.
Organisational support to GPs should be increased, including HR, data and estates management.
A PCN should offer an increase in capacity and capability and if you’re not already, explore working together. How can you collectively manage back-office functions and develop and better support practices and the PCN?
The report contains many more recommendations, but these are the more obvious ones general practice and a PCN can immediately work on. There are also others that could be explored or discussed with their ICS and could bring immediate benefits to practice, staff and patients.
Our advice to general practice and PCNs is always to look forward. Our ‘Sustainable Practice’ and ‘Thriving PCN’ programs help you do that, and ‘The future of general practice’ report contains some useful pointers to get you started.
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