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GPs go forth

Every CCG to get £6 per patient to extend GP access from 2019

All CCGs will be expected to extend GP access on evenings for an extra £6 per patient from April 2019, but weekend opening will 'depend on local demand', NHS England has said.

In the first detailed account of how NHS England will fulfil the Government's mandate of weekend and evening access to general practice, it said total recurrent funding would reach £138m by 2017/18 and £258m by 2018/19.

NHS England explained to Pulse that CCGs would have to commission at least an extra hour and a half of evening appointments, while Saturday and Sunday opening would be flexible depending on local demand.

It comes as the GP Forward View pledged that by 2020/21, over £500m in additional funding annually would enable CCGs to commission 'access to GP services, including sufficient routine appointments at evenings and weekends to meet locally determined demand, alongside effective access to out of hours and urgent care services'.

Today's announcement said 'this will contribute to the overall ambition of investing an extra £2.4bn in general practice services by 2020/21' that was pledged in the GP Forward View.

As previously revealed by Pulse, the funding of £6 per head of population will be made available to GP Access Fund (formerly known as Prime Minister's Challenge Fund) pilot sites during this financial year. NHS England said this would extend to 'a number of additional areas across the country' in 2017/18.

It said the money would also fund an extended access programme covering the whole of London starting this year.

In today's announcement, NHS England said that 'the investment will be extended in 2018/19 to enable the whole country to start developing additional capacity, so that from April 2019 every CCG can expect a minimum additional £6 per head to improve access to general practice'.

The planning guidance document said that it is a 'must do' for CCGs to 'extend and improve access in line with requirements for new national funding' by no later than March 2019.

The document also sets out that by 2018/19, CCGs have to 'ensure' the sustainability of general practice by implementing the GP Forward View - including plans to extend capacity in practices, increasing the number of GPs, co-funding pharmacists to work in general practice, expanding IAPT with more primary care-based theraists, investing in training practice staff, extending online consultations, supporting GP practices to work at scale as MCPs or PACS and 'enable and fund' primary care to 'play its full part' in implementing 'the forthcoming framework for improving health in care homes'.

Dr Arvind Madan, NHS England’s director of primary care, said: 'We know that general practice is under pressure and we are determined to maintain the momentum in turning things around, as started with the launch of the General Practice Forward View.

'Today’s planning guidance, with detail on how investment will look in the coming years, demonstrates the steps we will be taking with CCGs to both stabilise and transform GP services in the years to come, for the benefit of staff and patients.'

GPC deputy chair Dr Richard Vautrey said: 'It appears that NHS England have learnt from the lessons of many of the pilots which showed that there was little demand from patients for routine weekend appointments. There is importantly now no requirement to be open 8-8 on Saturdays and Sundays, with flexibility based on local needs.

'It is sensible that extended hours appointments will also be available for urgent appointments.

But he added that the £6 per patient recurrent funding was 'considerably less' than many of the GP Access Fund pilot areas have received to date.

He said: 'They will now need to cut their cloth according to this reduction in funding. With a shortage of GPs and reduced funding they will also have to consider using other health professionals to provide these appointments.

'In addition we would expect CCGs to work with GPs to integrate current out of hours and urgent care services to avoid duplication and make best use of the available resource.'

Dr Vautrey also welcomed the planning guidance mandating CCGs to ensure the GP Forward View measures are implemented.

He said: 'This is vital at a time when general practice is overwhelmed by unsustainable workload pressures leading to GP burnout and practice closures.'

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Readers' comments (45)

  • £6 per patient for the CCG but how much to the individual practice? How much will be lost plugging the funding gap in current CCG budgets - £5.99 per patient?

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  • Has anyone done research comparing how much money is spent on direct patient care when the money is given to the ccg as opposed to being given directly to practices?

    The assumption that 'GPs just pocket the difference' is quite lazy, and may be difficult to justify when so much of what is supposedly given to CCGs for primary care is 'topsliced' and generally accounted out of existence.

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  • £6 - needs to be about three times that

    You need to factor in MdU cover , staff costs, heating lighting etc etc

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  • Thats what we need.we need more money into NHS so that the quality of patient care is maintained.Currently NHS standards are very poor.

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  • They better not kill the extended hours DES.

    Practices need it.

    Staffing this will be next to impossible.

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  • Does this mean every practice will have to have routine appointments until 8pm every weekday or is it some kind of centralised CCG hub that will provide these appointments?

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  • Whoop dee woo.

    So it has taken various initiatives, pilots and reorganisations to start funding replacement for extend hours DES cut by this goverment!

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  • For wat it's worth we have not found there is a fixed amount of GP capacity and this gets spread over 7 days. Instead there is a significant group who want to do extra sessions if the work environment is attractive. Money is not the key factor because partners could earn a lot more doing extra days in their surgery. Overall cost per appointment is similar to employing a locum.

    For all the schemes I am aware of this is a big increase in funding. Maybe the BMA just have some auto quote software that condemns any proposal.

    Ironically what is being proposed is almost identical to the proposal from the BMA. Only difference is they want appointments to start in the afternoon rather than 6.30pm.

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  • Evening appointments for busy folk so ill they couldn't see a Dr during the day cause they've been at work. This genius idea pushed massively by Gordon Brown is not a solution to the problem of a lack of capacity in general practice. It is though a way of increasing demand. Folk who'd rather not (and currently don't) come during the day , cause it's inconvenient and they have 'more important stuff to do' , rock up at 7:30. These are additional consultations to the ones done already. When people ring up their surgery for an appointment and can't get one for two weeks, they don't scream to themselves 'what I really want is to see my Dr at 9pm!' ...what they scream is 'why aren't there enough appointments during the bleedin day...I just want to see a flipping GP!'
    Shifting Drs from the day to the evening is basic bull ...pure and simple.

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  • Vinci Ho

    My question remains , are GPFV and this document really going to stop present GPs leaving prematurely and attract more young GPs joining ? Only if one puts these into perspectives can see whether a 'solution' is really a solution .
    The first few lines of Alanis Morissette's fabulous 'Ironic':
    ''An old man turned ninety-eight
    He won the lottery and died the next day
    It's a black fly in your Chardonnay
    It's a death row pardon two minutes too late
    And isn't it ironic... don't you think''

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