GP Forward View

Background

The General Practice Forward View (GPFV) was published by NHS England in April 2016 and came with a commitment of “an extra £2.4 billion per year to support general practice services by 2020/21” with the aim of “improving patient care and access and investing in new ways of providing primary care.” The plan was developed with the Royal College of General Practitioners and Health Education England and contains many steps to:

  • channel investment
  • grow and develop the workforce
  • streamline the workload
  • improve infrastructure
  • and support practices to redesign their services to patients.

The original document (https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf) and a set of slides produced by NHS England (GPFV event slides – for distribution) sets out the plans. There have been quite a lot of changes since these came out, and there continues to be new announcements or developments, so we would encourage you to look through the main website (https://www.england.nhs.uk/gp/gpfv/) and keep an eye out for updates from us through the usual means.

The GPFV in Doncaster

In December 2016, the CCG was required to submit our local GPFV plan for NHS England. This followed discussions after November’s TARGET sessions with our member practices where we set out our intention to, where appropriate, channel GPFV funds and non-financial support through our Primary Care Strategic Model. The plan is available here

What has happened so far

Nationally:

  • Changes to the GMS Contract for 17/18 including an uplift to the global sum (https://www.england.nhs.uk/gp/gpfv/investment/gp-contract/)
  • Winter Indemnity Scheme for out of hours sessions has run again from October 2016 until 30 April 2017, alongside a short term GP Indemnity financial support scheme to offset average indemnity inflation for an initial 2 years (https://www.england.nhs.uk/gp/gpfv/investment/indemnity/)
  • Schemes (https://www.england.nhs.uk/gp/gpfv/workforce/) have started around recruiting and retaining doctors in general practice
  • The NHS GP Health Service has now launched, offering a confidential service to GPs and GP trainees.  They can help doctors with issues relating to a mental health concern, including stress or depression, or an addiction problem, in particular where these might affect work. More information is available here (http://gphealth.nhs.uk/), including a leaflet outlining how to access the service (http://gphealth.nhs.uk/2017/02/08/nhs-general-practitioner-health-information-leaflet/)
  • The Clinical Pharmacist pilot (https://www.england.nhs.uk/gp/gpfv/workforce/cp-gp/)  is being run again with the same NHS England contribution towards the costs of recruitment and employment as the initial pilot:
    • 60% in year one
    • 40% in year two
    • 20% in year three
  • The Estates and Technology Transformation Fund (ETTF) programme has started. Although this was intended to be a rolling programme, it is very highly oversubscribed already. The CCG is working closely with our NHS England colleagues and practices with proposals in the different cohorts to understand the implications of this on the plans initially put forward

Locally:

  • Providing funding for backfill for 5 GPs to attend the GP Improvement Leader Programme in Leeds between May and July
  • Use of the 16/17 funding for training for reception and clerical staff to arrange a variety of training sessions over the coming months around care navigation, medical correspondence training, Practice Manager development and a familiarisation event between practice and community pharmacy staff. The dates for these sessions are at http://primarycare.doncasterccg.nhs.uk/134/gp-forward-view-upcoming-training-opportunities-april-to-june-2017/ 
  • The CCG put forward a number of practices for support through the General Practice Resilience Programme in 2016/17. Funding within the programme that hadn’t been allocated by the end of this process is now being used to facilitate initial discussions and support a work programme between the emerging collaborations/federations in Doncaster with the aim of forming a single Doncaster-wide federation. Primary care working at scale, including federations, is seen nationally as playing a key role in building resilience and securing the sustainability of general practice. The LMC are involved with the work to make sure that practices that are not currently affiliated to any of the collaborations are represented.

What is coming soon

  • Proposals for most effectively using the non-recurrent £3 per head for practice transformational support. The investment is designed to be used to “stimulate development of at scale providers for improved access, stimulate implementation of the 10 high impact actions to free up GP time, and secure sustainability of general practice.” We are working with the federation(s) and LMC to look at different options for this funding that will support the Responsive Primary Care pillar and preparing to meet the extended access requirements from 2018/19 (when the non GP Access/Prime Minister’s Challenge Fund sites begin to receive funding to provide this)
  • How we will use the 2017/18 funding for training for reception and clerical staff to provide Care Navigation training. More details will follow after the first Care Navigation Workshop on 7th April, which will have local stakeholders review how the different local services can be navigated.
  • We have had an initial meeting with the development advisors we have been allocated following our expression of interest in the Releasing Time for Care Programme (https://www.england.nhs.uk/gp/gpfv/redesign/gpdp/releasing-time/). They will be coming to present and discuss implementing a local Doncaster programme with a group of GPs, practice managers and other practice staff in the afternoon on 15th June – details to follow about who/how to get involved. Local programmes are usually based around the implementation of one or two of the 10 High Impact Actions between groups of practices.

  • On a related front, the development advisors potentially gives us access to the Productive General Practice (PGP) Programme. This is a deeper dive into processes at a practice level and making changes to improve productivity, it involves the team coming to the practice and staff within the practice meeting and working together on the change on a regular basis. The CCG is working with those involved in the federation work programme to identify practices who would benefit from this and are willing to commit the time and energy required to engage with it; we would only be able to put forward a proportion of our practices for the programme

What are we still waiting to find out about

  • Guidance around the use of funding allocated for online consultation systems from 2017/18 onwards – this is expected imminently
  • Clarity on the expectations around extended access set out in Annex 6
    (General Practice Forward View planning requirements) of the planning guidance. The guidance sets out the additional capacity required to be commissioned alongside the time period and funding to achieve this but it’s unclear how this fits with “additional” capacity we already have e.g. Extended Hours DES, Same Day Health Centre, GP streaming at A&E
  • The funding and criteria for the GP Resilience Programme from 2017/18 onwards
  • How the extra workforce numbers promised in the GPFV, including 5,000 new GPs, 3,000 new fully funded practice-based mental health therapists and 1,000 new physician associates will translate into actual new workers in Doncaster
  • Any details about the national practice manager development programme
  • The national programme to help practices support people with long term conditions
  • New technology and self care including an approved apps library, more online self care services and fully IT interoperability across practices