GP rescue package 'failing to make improvements on the ground', finds RCGP
The RCGP has 'red-rated' several aspects of NHS England's work to roll out last year's GP Forward View rescue deal, as part of a comprehensive review into its progress.
The college had been the biggest supporters of the GP Forward View when it was released last April, but chair Dr Helen Stokes-Lampard expressed 'frustration' that GPs weren't seeing the benefits as yet.
The report today released by the college found that NHS England has failed to implement measures to support practices in danger of closing, and failed to follow through with its commitment to review QOF.
It also said that the blueprints on the future of the NHS being drawn up by commissioners across England had failed to make sufficient efforts to stabilise general practice.
However, it also said that there had been some good progress on certain issues, such as a new occupational service for burned out GPs and schemes to retain GPs, and make it easier for GPs on career breaks to return to the profession.
But the college's criticisms come as a blow for NHS England, as the RCGP had badged the document, with chair Dr Maureen Baker calling it the 'most significant news for general practice since the 1960s' and later stating it should be 'everyone's top priority'.
The top concern is over the under-spend of funding set aside to save practices that are struggling for their survival, which Pulse reported yesterday.
But it has also 'red-rated' two other pledges included in the GP Forward View, including the review of the QOF. The report states that despite pledges, 'a review will not be concluded this year'.
The other key concern relates to NHS England's pledge to fund up to 100% of the costs of premises developments, rather than the previous cap of 66% - an issue previously highlighted by Pulse.
However, it found that the new rules 'have not yet been issued and are now expected in February 2017.'
The RCGP has also looked at the 44 regional NHS Sustainability and Transformation Plans (STPs), finding that general practice is 'frequently seen as a solution to problems in secondary care, without sufficient efforts made to stabilise and support it'.
The RCGP is also concerned STP are failing to set out 'robust' workforce plans for general practice, and - as also previously highlighted by Pulse - warns that some even 'foresee a decrease or stagnation in GP numbers'.
There is positive progress made since the GP Forward View was published, it said, including the £16m GP mental health service launched earlier this week, improvements to the induction and refresher scheme and the short-term measures to counter the effects on GPs of rising indemnity costs.
RCGP chair Professor Helen Stokes-Lampard said the GP Forward View had the potential to be 'a lifeline' for the profession 'if implemented correctly at both a national and local level', but added that although there 'has certainly been some positive progress' there is a 'huge amount of work to do at a local level to ensure that family doctors begin to notice improvements on the ground'.
She said: 'It's incredibly frustrating to hear that pots of money are just sitting there waiting to be spent – money that has been earmarked for struggling practices. NHS England needs to be out there, making sure the practices who could benefit from this money know about it, and making it easy for them to access it.
'Also extremely concerning is the lack of recognition for general practice in many STPs – this is against all common sense, against all the evidence about how to run an efficient health service and against NHS England’s own guidance.'
The RCGP's progress ratings for the GP Forward View pledges
'NHS England will introduce a practice resilience programme worth £56m over five years, with £16m available in 2016/17.'
'NHS England will undertake a review of the Quality and Outcomes Framework (QOF) in 2016/17.'
'NHS England will introduce new rules from September 2016 which will enable NHS England to fund up to 100% of the costs of premises developments, rather than the previous cap of 66%.'
'For 2016/17, NHS England will allocate an additional £322m in primary medical care allocations, providing for an immediate increase in funding of 4.4%.'
'NHS England and the Department of Health will bring forward proposals to tackle rising indemnity costs in general practice. In a related commitment the Department of Health will consult on options for introducing a Fixed Recoverable Cost scheme in clinical negligence claims.'
'Health Education England will increase GP training recruitment to 3,250 per year.'
'NHS England will increase the financial compensation available through the current GP retainer scheme from 1 May 2016, and to introduce a new GP retainer scheme more fit for purpose from 1 April 2017.'
'NHS England will introduce new standards for hospitals to improve the interface between hospitals and general practice.'
'NHS England established a Rapid Testing Programme in three sites to review ways of better managing outpatient demand. The GP Forward View will see the most effective measures emerging from this programme would be rolled out from late summer 2016 onwards.'
The maximum interval between inspections for practices rated good or outstanding will move to five years, and a new streamlined approach to inspection will be introduced for new care models and federated practices.'
'NHS England will bring forward £30m "Releasing Time for Patients" development programme to release capacity within general practice.'
'NHS England will invite CCGs to put forward recommendations for investment in primary care infrastructure and technology by the end of June 2016.'
'Changes will be made to NHS England’s Induction & Refresher scheme for doctors returning to work in English general practice.'
'NHS England and Health Education England will evaluate the Targeted Enhanced Recruitment Scheme, which offers £20,000 salary supplements to GP trainees committing to working in hard to recruit areas.'
'NHS England will invest a further £16m in a new national service, beginning in December 2016, to improve GPs’ access to mental health support.'
'NHS England will ensure practices are appropriately compensated for future CQC fee increases. They will publish a set of key "sentinel" indicators for quality in general practice on My NHS in July 2016.'
'NHS England will launch a national programme by September 2016 to help practices support people living with longterm conditions to self-care.'
'NHS England will agree arrangements for May 2016 to October 2017 to provide additional support to practices in three areas.'
'NHS England will introduce a range of core requirements for technology services to be provided to general practice.'
'The rollout of access to the summary care record to community pharmacy will be completed by March 2017.'
Source: RCGP GP Forward View Interim Assessment