PCNs taking part in a new pilot scheme will receive a 10% funding uplift for more GP clinical staff to ‘accelerate’ delivery of the long-term workforce plan.
The scheme is designed to ‘test’ whether implementing the plan, along with other digital tools such as process automation, can plug gaps in general practice capacity.
Between 15 and 20 ‘test sites’ across England will gather extensive data over the next three years in order to understand whether these interventions make a difference compared with the current ‘baseline’.
Last month, NHSE announced that seven ICBs will oversee a PCN pilot scheme in order to test new ways of working in GP practices and build on delivery of the 2022 Fuller stocktake.
A recent information pack for GPs, seen by Pulse, laid out the national plans in more detail, revealing that it will run until the end of March 2027, and will provide test sites with three streams of funding.
PCNs, or PCN-size groups of practices, will receive funding for ‘more clinical capacity’ which will ‘accelerate’ the test sites to the 2028/29 long-term workforce plan model.
The information pack said the test sites will receive funding to ‘expand clinical capacity by ~10%’.
It is not clear which part of the £2.4bn long-term workforce plan test sites will deliver on, given that its ambition is to increase GP training places by well over 10% by 2028, from 4,000 to 5,000.
Pulse has asked NHS England to clarify how the pilot PCNs will align with the long-term workforce plan and whether the expanded clinical capacity will include both GPs and other professionals.
The extra funding will come through the GMS contract and the PCN DES, and in an example given for a 50,000-patient PCN, practices would receive £300,000 for 2024/25 and £1.1m in 2025/26.
ICBs will also provide funding for other interventions, which will be agreed upon with PCNs, such as digital tools for ‘risk stratification’ or ‘repetitive process automation’ to reduce admin.
To build on the Fuller stocktake, NHS England also wants participating PCNs to explore ‘best practices’ for proactive population health management and for the care of complex or frail patients.
ICBs will support PCNs by ‘co-ordinating resourcing for MDTs’, such as provision for a consultant geriatrician.
Practices involved will be expected to carry out an audit to collect key data every eight weeks, and to help resource this, ICBs will provide funding to ‘compensate for intensive and iterative data collection exercises’.
The programme, which is described as a ‘before and after study’, will begin in September with data collection to commence the following month.
The outline plan said ‘there are many areas where better data could inform both local and national policies/ strategies’, such as addressing the gap between demand and capacity, the ‘optimal use’ of ARRS staff, and ‘how to get the benefits of both scale and small teams’.
The pilot ‘aims to fill many of these gaps’ and ‘support a path to a more sustainable future for general practice’.
In order to take part, PCNs must have implemented ‘modern general practice access’, as stipulated by the primary care recovery plan, and must have ‘no remedial contract notice or breach in the last 12 months’.
The outline plan for the pilots is:
- Establish a baseline of demand, resource, costs and economics for each test site by conducting a three-week long data collection exercise;
- Then ‘accelerate’ the test sites into 2028/29, with a range of interventions, digital tools and expanded clinical capacity to align to 28/29 long-term workforce plan;
- Then run ‘audit weeks’ to collect key data for quality improvement purposes.
This study will give NHS England the ‘ability to calculate any capacity gap in the 28/29 model’.
What the pilots seek to establish
- How large is any gap between general practice demand and capacity?
- Is the long-term workforce plan implied 28/29 capacity sufficient to close the gap?
- How do variations in practice income impact levels of clinical capacity?
- How much of GMS and PCN DES income is allocated to clinical/admin/managerial capacity?
- What are the other drivers of variation in clinical capacity? (e.g. skill mix, primary/secondary care interface)
- Which interventions should be prioritised nationally, to help close any demand-capacity gap?
- What drives variation in patient experience today, and what are best practices? (e.g. differing workforce skill mix, digital methods)
- What drives variation in staff satisfaction today, and what are best practices?
- What are best practices to maintain/improve continuity as GP model evolves?
- What is the optimal measure for it?
- How to organise clinical staff
- How to leverage digital methods
- What is the variation in spending across ICBs on primary care services?
Source: Somerset ICB webinar on 16 June 2024
Earlier this month, NHSE’s chief executive Amanda Pritchard said these pilots will be ‘integral to the future of the NHS’ and that a ‘modern vision for primary care’ is needed.
National director of primary care Dr Amanda Doyle has also said the pilots are ‘not a top-down NHS England thing’ and that participating PCNs will ‘test out some hypotheses’.
But BMA GP Committee England chair Dr Katie Bramall-Stainer criticised the pilots, and urged GPs not to take part, in her recent speech at the UK LMCs conference.
She argued that ‘nothing’s going to change’ and told GP leaders who are engaging with pilots to ‘stop it, stop it now’.
Yeah, more data is absolutely what is needed. Usual 30 pieces of silver for ‘early adopters’ willing to accede to NHSE bidding.
Another insulting and effortful waste of Practices’ time; PCNs instructed to measure another pig with another promise that all patients need is more commercial IT solutions chasing our tails. I am glad Dr Bramall-Stainer has the measure of DHSC/NHSE and their pliant advocates.
They will keep trying to rearrange the deck chairs on the NHS Titanic.
The answers are not rocket science.
Fund General Practice properly. Get rid of the sh*t bureaucracy and bureaucrats the make the job crap.
Make it rewarding to be a GP partner again. In the the long run they make the NHS more efficient and deliver better patient care.
Stop fiddling about while the NHS burns out
Meant to say, that make the job crap.
Who are the people in NHSE making these decisions? How do they get their jobs? Who picks them and why? It’s these people who have destroyed primary care. It’s these people who continue to come up with stupid bean counting projects implementing stupid ideas from ignorant politicians. Mediocre, nice, they look reasonable and they are compliant. They make it all sound legit. They’re Drs. They’re GPs. All carefully chosen not to look offensive, kind, just doing the best they can, doing as they are told, making the best of it? Spineless facilitators. History will judge you poorly. The names are there. All sincerely explaining away the necessity for this years insanity. Like money launderers for the mafia. Take a look and you can see who they are. Never blamed but always there to break the sad but compulsory news that things have to be done more stupidly next year. Thanks guys but I see you for what you are even if you dont
Anthony ROBERTS you have hit the nail on the head. This diversion of funds from practices to PCNs will make access worse.
Ditch ‘fuller stocktake’
Ditch these wasteful pilots
Fund core GP
The best thing is by challenging these decision making guys openly and asking how they are coming to decisions with the inclusion of colleague who will supervise the ARRS and the patients themselves. Why should not we replace these ICB decision makers with administrative assistants and other clerical / cleaning who also will brings great skills to the mix. They may. be cheaper than these ICB decision makers and make better decisions.
Ditch the Fuller nonsense. Stop wasting money on ‘pilots’ like these and use the money to employ more GPs.
All practices need the funding for at least 1 GP pro rata. So larger practices get the funding for more WTE.
More GPs then more pro active care. Currently just mean acute demand and struggle for capacity.
Small cost compared to hospital budgets but would be transformational for patients in primary care
Our local political organisations have had to cancel meetings during Purdah, blocking their ability to fund campaigns.
Meanwhile, the government departments, such as DoH/NHS, the specific organisations whom Purdah was meant to forbid making announcements that might improperly influence public opinion of the current Government regime, seems to be getting away with it !
But GPs are far too bright, and will see through this gimmickry – well, most of them anyway !
More BS bingo
PCNs have been a clandestine vehicle used by ill-informed governments to legitimise the covert use of financial inducements in my view as a from of bribery to inflict devastation upon an already beleaguered and failing NHS system weakened by years of mismanagement by NHSE /CCG/ICB / LMC (yes LMC)/ RCGP )/ GPs using these positions to gather information and to feather their own nests at untold cost to patients and their colleagues and particularly younger aspiring doctors/GPs.
Of course, there are exceptions, but this is the point -they are increasingly becoming exceptions.
These groups deceive and manipulate the profession masquerading as doing good while perpetrating appalling levels of damage to patient care while quietly receiving vast payments in return. They rarely openly declare their own financial incentives.
Constantly mentioned over time , these duplicitous GPs occupying positions of influence not for the good of the profession but for the good of their own personal bank balance or possible a trip to the Palace for an undeserved accolade or title as recognition of their own self-gratification continue to circulate backed by NHSE managers with whom they collude.
Unsavoury issues have been raised on Pulse (kindly allowing this on this forum), that the ineptitude of the government has only been possible via these constantly appearing regular GP names in PCN,CCG/ICB board, ICB lead , RCGP or LMC positions.
These individuals over the past decades through past involvement in reckless ill-considered experimental lunacy and Pilots, APMS contracts etc have fragmented NHS patient care in to a thousand parts wherein all could be delivered by individual effective well supported GP practices.
They have decided to fragment and destroy wherein the answer was to support and expand the individual GP practices of the UK.
Those who have destroyed general practice need to be held to account for the irreparable damage they have caused.
The past damage caused by PCNs, PCN CDs and these perennial board ICB/NHSE etc GPs in relation to the NHS as a whole, patient related damage, mutilation of the careers of younger GPs and other GP sectors cannot be repaired .
However, the battle is not yet over but it requires painful resistance by those who believe more in the NHS than the power of money against these overly influential PCNs, PCN CDs, NHSE etc. and those in the government who lack understanding of the NHS and yet impose ludicrous pilots and change at irreparable cost to all.
These GPs need to be held to account.
Yet another gimmick promoting skill mix and “working at scale” with PAs and other Noctors, set up to undermine General Practice.
What worries me about NHSE announcing this divisive bribe scheme (for its usual GP collaborating sellouts), during purdah, is that civil servants have already also agreed this scheme with the next Govt (? Labour). Will have to wait and see..