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Independents' Day

NHS England 'urgently' working on practice boundaries contract details

NHS England still hasn’t finalised the details for plans to allow GPs to take on patients from outside their boundaries without having to provide home visits, despite the scheme beginning in October.

Speaking at the Commissioning Show conference in London today, NHS England’s head of primary care commissioning and York GP, Dr David Geddes, said that NHS England was having ‘issues’ getting safeguards in place before October, when GPs will be able to register patients from outside their traditional boundaries.

Dr Geddes told the Commissioning Show audience: ‘[Lifting practice boundaries is] enabling patients to have a GP where they work, rather than where they live. And that creates issues for us in NHS England. How will we make sure that patients when they’re ill have access to a home visit, for example?

‘It’s up to the area teams to commission that from the home where the patient lives, the home practices. That might be something we might do jointly with CCGs, it may be through another system.

‘The way we’re exploring it at the minute is that, if I’m a patient registering with a London GP because I’m often down in London, then who’s going to look after me in York? What kind of contract will have to be developed so the GPs in York can look after me when I’m particularly poorly? There’s work to be done on that – that comes in in October, so it’s quite urgent.’

Dr Geddes also announced that NHS England is developing a new GP toolkit for practices to report recruitment and vacancy data, and aid workforce planning.

The tool will allow practices to report currently unfilled positions, nurse staffing levels and skills, and time to retirement of existing workforce, and is to be used to identify recruitment blackspots.

Dr Geddes said: ‘This year we want to be able to launch an up-to-date means by which practices can identify their workforce, their vacancies, who their nursing staff are, the skills that nurses have, and also the clinicians – in terms of where they are on the way to retirement, how long they feel they’ll continue to work.

‘We need that data on a very granular level in order to be able to start making plans, because we know there are areas which are under-doctored now, which have been under-doctored for years. We need to start to pull together with health and social care, with area teams and CCGs and with local education training boards to start populating doctors in those areas, and nurses.’

Readers' comments (12)

  • I fully support the notion of workforce planning. It .may shine a light on a problem that the DOH seems to deny exists

    Two flies in the Sudocrem though
    1)Without action to deal with the underlying issues it will achieve nothing.
    2)I am told that it is hugely bureaucratic to complete. PM's are just as overwhelmed as GP's these days and the extra workload is not welcome.

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  • I'd like to register with a GP where I'm at work so I can see them when I'm well...of cause I don't need to see my GP at home...I'm never there...cause I'm at work..because I'm well. I can't image a time when I'd be at home and need to see a GP...only weak people do that ..the ill ones..I don't generally get ill..that's why I'm at work. We need to be ensuring access for working well people...who cares about the sick people..they need to get off their back sides and find a job me.

    If and went I do actually get actually ill and I can't go to work ...well at least then I can re-register with a different Dr where I live who's never met the middle of an acute illness ....I just hope I'll be able to get an appointment ...what with all the well people booking appointments too...then I can continue to get the medical care that I actually need a Dr near where I live..cause then I won't be at work I'll be at home cause I'll actually be ill...but the Dr won't know me....bummer

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  • absolutely irrelevant stupid populist non evidence based wasteful idiotic schemery...while the core of primary care dies on nhse's watch all they do is creep and pander before this desperately incompetent government and its sick corrupt scheming to try in the vain attempt to win re-election
    overwhelmingly usual from nhse.

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  • This policy may be a trojan horse. If CCGs are going to morph into insurance based organisations then the way to get care is for patients to need to have a GP.

    Groups such as Virgin will probably cherry pick patients from all over, who are healthy. They will not want to stick to boundaries or provide home visits.

    Your traditional GP surgery will not be able to provide care on the capitation fee unless they too cherry pick. Gradually it will be providers that pick their patients. Far from patients getting a choice, they may not be able to get health care at all if they cannot join a GP list because they have expensive health care needs, all revealed by their CARE data.

    The future is very sinister and I can hardly believe what has been so carefully planned.

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    This explains why the lack of GP boundaries is important, to break up the NHS and universal care.

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  • In the south east every spare bit of ground is having houses thrown up. As a result our list size is rising quicker than we can plan for as when the houses are being built no infrastucture has been planned - so will I be offering to visit patients that are not our own - what do you think - this was a harebrained idea that has not been thought through - NHSE will be left with egg on its face trying to find practices to treat our highflyers that did not want to take time to be registered or seen in their own locality - I see A & E picking up the slack - no reduction in hospital attendance there then - you couldn't make this nonsence up

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  • We already have patients from nearby Maidstone and Gravesend trying to register with our Practice and can see the danger of being innundated. Until it is clear what the terms look like, it is difficult to say whether taking on these patients will be worthwhile. The sooner the details are made available, the better it would be for planning.

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  • I agree that this is a vital part of the plan to have national contracts for general practice with large private organisations such as Virgin or Care UK.
    If David Lloyd membership entitles you to visit any other David Lloyd gym, anywhere in the country, it can be done for general practice. Equally you can take a purchase back to any branch of MandS or Currys because they all share the same computer system.
    If local GPs refuse, it will be another reason for the government to hail the " integration" provided by their private friends.

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  • True integration is expensive.

    FOr all the talk of saving money with prevention and health improvement, the only reliable way to save money is restriction of access.

    The Virgins of this world are not really interested in primary care - its too expensive and the margins are far too small. There is a case for top slicing and for them focusing on single health episodes

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  • just bit the bullet and switch to a tariff based contract. pay me as a GP for each pt I see. I'll open all hours and see anyone from anywhere.

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