New GP models of care to cover half of all patients by 2020, says DH
At least half of England’s population should be covered by the new GP care models that will see single organisations providing primary and secondary care by 2020, the Department of Health has told NHS England.
The DH has mandated NHS England to ensure that 100% of patients have access to weekend and evening routine GP appointments by 2020 - even though only 3% of responses to the consultation were supportive of routine seven-day GP services.
NHS England has also been told to develop the voluntary GP contract announced by Prime Minister David Cameron - now named the ’Multidisciplinary Community Provider contract’ - ready for implementation in 2017/18.
The requirement for 50% of patients to be registered with new models of care follows the plans set out in NHS England’s Five Year Forward View, published last year, which described GPs and hospitals working together in larger organisations providing ‘step-down’ beds, homecare, counselling, dentistry and district nursing, among others.
This year, NHS England announced the the ‘vanguard’ pilot projects that would be trialling the new models of care.
Now, the DH mandate has said that the new care model should be ‘covering at least 50% of [the] population’ by 2020.
It also said that NHS England should deliver ‘a measurable reduction’ in emergency admissions and emergency in-patient bed days by 2020, and the reductions should be greater in areas covered by new models of care.
Other targets introduced by the mandate include:
- NHS England publishing practice-level metrics on quality of and access to GP services;
- No patient waiting more than 28 days for an all clear or a cancer diagnosis;
- A reduction in childhood obesity;
- An increase in number of patients referred by a GP getting a dementia diagnosis within six weeks, by 2020.
- A new range of ‘Ofsted-style’ CCG level indicators, which includes clinical outcomes, to be rolled out by June next year.
The DH updates its mandate to NHS England annually but, because of the recently concluded Spending Review, the document published today covers both 2016/17 and wider objectives to achieve by 2020.
The Government has twice before publicly consulted on the NHS mandate, but it said the number of responses from the public was unprecedented - 127,400 responses, compared to just over 150 in the previous years.
The public was mainly concerned with ‘the extent of private sector involvement in NHS services’, as well as the viability of plans for a seven-day NHS due to a perceived lack of funding and pressure on NHS staff.
In all, ‘fewer than 3%’ were supportive of seven-day services. However the DH said its mandate was ‘not an agenda for privatisation’ and reiterated that it was ‘committed’ both to same quality of service in urgent and emergency hospital care seven days a week.
It also said it would ‘make sure that GP appointments are available when people need them, including at evenings and weekends’.
It said this would be possible by increasing the primary and community care workforce by 10,000 by 2020, ‘including an additional 5,000 doctors working in general practice’.
NHS England’s mandate for ’New models of care and General Practice’
Overall 2020 goals:
- 100% of population has access to weekend/evening routine GP appointments.
- Measurable reduction in age standardised emergency admission rates and emergency inpatient bed-day rates; more significant reductions through the New Care Model programme covering at least 50% of population.
- Significant measurable progress in health and social care integration, urgent and emergency care (including ensuring a single point of contact), and electronic health record sharing, in areas covered by the New Care Model programme.
- 5,000 extra doctors in general practice.
- New models of care covering the 20% of the population designated as being in a transformation area to provide access to enhanced GP services, including evening and weekend access and same-day GP appointments for all over 75s who need them; and make progress on integration of health and social care, integrated urgent and emergency care, and electronic record sharing.
- Publish practice-level metrics on quality of and access to GP services and, with the Health and Social Care Information Centre, provide GPs with benchmarking information for named patient lists.
- Develop new voluntary contract for GPs (Multidisciplinary Community Provider contract) ready for implementation in 2017-18.