The NHS Long Term Plan. What's in it for Primary Care?

This month a groundbreaking GP contract reform deal for the NHS has been revealed, which aims to make a far-reaching impact on healthcare sector staffing, costs and efficiencies whilst, at it’s heart, unburdening the over-worked and dwindling GP workforce to improve patient care.

Here’s our take on the 5-year agreement between NHS England and the British Medical Association.

Workforce

“By far the biggest challenge facing general practice is that it doesn’t have enough people to do the work required. This is creating unsustainable workload pressures. Helping to fix this problem is our top priority.” - The‘Investment And Evolution’ Contract Reform Framework.

A recruitment drive to hire around 20,000 non-GP/nursing staff will achieve a 16% increase on current total practice staffing and may see non-GP/nurse (“direct patient care”) workers such as pharmacists, physiotherapists and physician associates out-numbering GPs for the first time ever. The new recruits will free GPs to spend more time with the most needy patients.

In addition to this a new Fellowship Scheme and Training Hubs will provide the support necessary to maintain a supply of newly qualified nurses and GPs into the NHS.

Funding

Rapidly rising indemnity costs have been recognised by the government as a driver for retirement and retention issues; so state-funded indemnity cover for GPs and practice staff is likely to be warmly welcomed.

Hefty contributions will also go towards, amongst other things, recruitment of the new direct patient care workforce, extended hours funding and investment to enable a 2% pay increase for practice staff.

Efficiencies (a new patient experience)

The creation of multi-disciplinary practices serves the vision of the overall NHS Long Term Plan; centralising healthcare into community ‘hubs’ where the regular presence of direct patient care staff will more efficiently delegate the workload that is currently handled routinely by GPs.

New requirements and support to provide online and video consultations, as well as online booking and direct booking through NHS 111 will also make for a more convenient and accessible NHS.

The deal also puts quality standards in the spotlight, with £300m available to network practices based on their performance against a set of specified clinical indicators.

In summary

There is a lot to be welcomed in this agreement. If successful, it will result in a happier workforce and easier, more cost-effective staffing. The 5-year scheme will create an enlarged, multi-disciplined workforce with greater accessibility for patients. This is combined with measures to give NHS services priority above private provision (for example; a ban on promotion of private providers by network practices). The proof is in the pudding but we are excited to see this bold plan realised.

 

Sources:

HSJ (2017) https://www.hsj.co.uk/policy-and-regulation/major-gp-contract-reform-revealed/7024312.article

‘Investment And Evolution’ - Contract Document (January 2019) https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf