Pilots of new ways of working for GP practices – modelled on the Fuller Stocktake – will be ‘integral to the future of the NHS’, NHS England’s chief executive said today.
Amanda Pritchard was speaking at the NHS Confederation Expo in Manchester today when she said that the NHS needs ‘a modern vision for primary care’, and that pilots coordinated by ICBs across the country to test new ways of working for practices will be ‘integral’ to the future of the NHS.
Last month NHS England announced that seven ICBs will test new ways of using ‘more flexible staffing models’, data and process automation within general practice in a pilot scheme that could change the way the profession works.
NHS England did not go into detail about what the pilots will entail for GP practices, but said that ICBs should work with primary care networks. This will ‘further deliver’ on 2022 report by GP and NHS national medical director for primary care Dr Claire Fuller, they added.
Ms Pritchard said: ‘We need a modern vision for primary care. And two years ago, Claire Fuller gave us one: streamlined access to urgent care or advice, proactive personalised care for patients with long term needs and helping people to stay well for longer. It’s a vision we can all get behind.’
She said that the first pilots are now exploring ‘the big questions’ around how to ‘make it easier for practices to meet urgent demands’ alongside continuity of care and preventative work.
She added: ‘I know there is no shortage of ambition among GPs and their teams. There are examples like that across the country. We want the ambition they show to be the norm. And it can be if we give primary care the tools they need. So, what happens in those pilots is going to be integral to the future of the NHS.’
Earlier today in a different session at the conference, attended by Pulse, NHS England’s national director of primary care Dr Amanda Doyle also mentioned the pilots, which she said are ‘not a top-down NHS England thing’, but that the commissioner is working with ICBs to ‘test out some hypotheses’.
The ICBs involved in the pilots are:
- Humber and North Yorkshire
- South Yorkshire
- Gloucestershire
- Somerset
- North Central London
- Lincolnshire
- Suffolk and North East Essex
Dr Doyle said: ‘They’re not pilots in the “try a new thing and evaluate it in two years and see if it works”. They are a test sites, and will be 15 or so PCN-size groups of practices or PCNs, who are testing out for us some hypotheses we’ve got and essentially are about getting information that we need to understand what that gap between demand and capacity is.
‘We know there is a gap between the ask coming in the door and what general practice is able to deliver. What we don’t know is the size of it is.’
She added that the pilots want to test what happens if general practice ‘works at sufficient scale’.
She said: ‘If NHS England stops trying to micromanage everything general practice does, if we try to meet what we think is the core capacity gap – and that’s financial as well as everything else – if we optimise everything else we can and particularly, we’re talking about use of digital tools, and some of the newer tools that are just being tested, then is general practice able to sustainably deliver the on-the-day demand, high quality, long-term condition management, the stuff we need to be doing around improving population health management, and proactive care for the people with the most complex needs?
‘Is that all doable and sustainable and what would it take to do that?’
Pulse has reported on ICBs putting forward plans to separate same-day access from general practice, leaving practices with responsibility for routine appointments only, which they have claimed is in line with the Fuller report.
However it seems these new NHS England-endorsed pilots could shape how the Fuller report is implemented more widely.
The Fuller stocktake, a landmark review on integrating primary care with other NHS services, recommended that GP practices form ‘single urgent care teams’ across ‘neighbourhoods’ to improve patient access.
It also laid out plans to develop ‘innovative employment models such as joint appointments and rotational models’ to counter the GP workforce crisis.
North West London ICB had been due to roll out same-day hubs from April this year but was forced to shelve plans due to a backlash from GPs and patients.
Of course Amanda — because of course GP at scale has never been tried before and failed.
Someone with an academic (or journalism) background needs to just do a fairly simple study.
Look at the top 100 practices in the GP patient survey, look at their size, number of doctors and one or two other fearures.
Repeat it for practices at the 10th 30th 50th 70th and 90th centiles
It’s pretty clear that the best practices
– are run by partners
– have 1000-9999 patients.
– have a dispensary
And I’m pretty sure practices run by trusts, corporations or part of mega-mergers are likely to be way down the list.
For what it’s worth I do know one very good practice that is part of a large group (50-100k patients) but that really is the exception. The best practices are smaller and more personal.
Well said, Bonglim.
But that wouldn’t require a pointless and expensive wholesale redesign that costs the earth and provides lower quality care, so NHSE aren’t interested.
Who are all these inoffensive nice smiling ladies who’ve been given chief roles in dismembering and chopping up General Practice? The chief of the RCP, NHSE, Fuller and now this lady ‘Amanda Pritchard’. All brought in to make everyone feel safe as they inject the lethal injection. I feel like a dog who’s been taken to the vets to be put down but it’s ok cause Amanda is here to hold my hand. I smell politics, manipulation and PR. Feck it all. This country has become an evil dishonest pit
What gobbledigook! It’s not a pilot but a test but test sites? Same thing! A there has already been a test of at scale working through pcns over the last few years. It’s called the extended access scheme and should give you all the data you need that it does not work. Remote clinics unable to arrange investigations so back to main GP site, quick fixes and see your GP in 2 to 3 days, and tasks back to main site GPs to arrange follow up and review. More appointments but most patients will end up back to the core practice to sort. A totally inefficient ineffective poor quality way of working.
‘We already know ‘GP at Scale’ means loss of continuity, loss of personal care, and consequently loss of quality. All the patient satisfaction surveys clearly show smaller practices are far more popular with patients. It’s the mega-practices which are unpopular.
If only the scales fell from Pritchard’s and Doyle’s eyes….
Modern vision my ar.. Insanity is doing the same thing over and over again and expecting different results. Only this probably isn’t insanity, it is rather a faiure of leadership delivered by tools with blind enthusiam for tools to deliver increasing healthcare demand on a shrinking budget by an increasingly unskilled workforce