Update: NHS England's plans to reform primary care
Here is a summary of NHS England’s new plans, with commentary from NHS England’s deputy medical director Dr Mike Bewick and GPC deputy chair Dr Richard Vautrey
GPs face further upheaval after NHS England launched a root-and-branch review of general practice last month, with a wide-ranging consultation running through to November. In the consultation document, the new governing body for the NHS sets out a number of topics on which it would like to receive views on reform to GP services.
Reducing the ‘tick-box feel’ of QOF
Background NHS England has said it wants a smaller QOF and health secretary Jeremy Hunt said in May that he was concerned by the amount of bureaucracy GPs had to deal with.
NHS England says ‘We don’t want people doing things that are not productive.’
GPC says ‘The profession has lost confidence in the QOF.’
Taking back responsibility for co-ordinating out-of-hours care
Background Again, Mr Hunt has said this is a priority, but 70% of GPs told Pulse they would not resume responsibility ‘at any price’.
NHS England says ‘It’s in the interest of GPs to make sure out of hours is done well.’
GPC says ‘That is a responsibility for CCGs and was one of the rationales behind the whole reorganisation of the NHS.’
‘Named GP’ for vulnerable patients
Background Another initiative championed by Mr Hunt, and backed in August by an NHS England review.
NHS England says ‘We want to stop people falling through the cracks and ending up being readmitted.’
GPC says ‘That’s what the contract delivers now, practice responsibility to ensure patients get the right services. Practices would like to do more of this but need some of their significant workload pressures taken off them.’
Incentives for inter-practice working
Background Groups of practices working together more closely is an idea the RCGP, the King’s Fund and Nuffield Trust have all backed to deal with funding issues, and competition.
NHS England says ‘It is important to have levers to get the best care out
of hospital that we can.’
GPC says ‘There are benefits, but we are wary of forming too-large organisations where the local connection with the patient is lost.’
Making it easier for ‘new market entrants’ to set up surgeries
Background Comes as Monitor collects evidence on access and competition in GP services to see if they ‘are working in patients’ best interests’.
NHS England says ‘Where primary care cannot cover areas, that is
a market we could open up.’
GPC says ‘If there is a need then that is fine. If it just duplicates what is already there, then they should just invest in the practices that are already there. ’
Addressing poor GP performance
Background Mr Hunt introduced plans for a more ‘holistic’ CQC inspection regime and a new chief inspector of general practice in February, after the publication of the Francis report.
NHS England says ‘Let’s have a systematic way of looking at the care provided, not just pick out a few areas.’
GPC says ‘There are improvements to be made to standardise performance management across the country, but we must take care not to over-regulate.’