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Independents' Day

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:

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.

2016-17 deliverables:

  • 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.

Source: Department of Health Mandate to NHS England 2016/17 (and to 2020)

Readers' comments (16)

  • The main problem being that there will be no GP's left to deliver the service .

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  • 2020 goal -5000 extra doctors in general practice . What is it that will attract them to this "failed" profession ,exactly ?

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  • Very laudable aims ; and ones that can easily be achieved with a 100% increase in budget .

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  • Even with large increases in funding I would be doubtful that this can be achieved . Many trainers are leaving the profession and it is estimated that 23% of the current GP workforce would need to become trainers to fill the gap and produce enough places to train the next generation of GPs . It seems likely that many of the new recruits would be heading for warmer climes.

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  • They're having a laugh. No new money. More work dumped. More scrutiny. Underfunded. Less GPs.
    leaving april 2016.
    younger GPs just get out of this

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  • Goals: 5000 extra doctors in general practice.

    this statement / goal has already been achieved

    they completely manipulate the facts and figures. Everyone knows there will be less FTE GPs than there is now. They will massage the figures counting every person who could feasible work in General Practice.

    They don't even know how many work last year and now.

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  • Lucky me.. Early in career and from a different country so off i go before all this c..p starts.Definitely not so much meddling from government in doctors routine work here but need to learn business sense a bit.
    Best of luck u guys as u just moan but don't do anything. Seen it for last 10 yrs.

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  • Vinci Ho

    I think the response from the public is self explanatory and the real message is 'Don't treat the public like idiots and insult their intelligence , you Tories!'

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  • 5000 more DOCTORS. Hmmmm, since primary care and secondary care will become one.... hospital doctors will be counted as working in GP, tadaaaaaa

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  • Vinci Ho

    (1) This is simply the rubber-stamping from Ministry of Truth. We have a Chinese saying in Hong Kong :' already have got the hair wet' which means there is no turning back as far as this government is concerned , no matter how rediculous , far-fetching and impossible this mission is . The bubble has been blown up so much.
    (2) From an objective angle of view , these politicians really need to think about how 'vulnerable' this project can turn out to be. The relationship between the government and medical professionals in this country is at all time low. Yes, you may have some Cameron/Hunt sympathisers but they are of minority at this current time. May be the number will increase by offering some financial incentive which is always the tool of typical economists. But there is a lot of unhappiness .
    (3) The temperature of unrest is rising at the moment : you have a health secretary who is carrying more than 220,000 votes demanding him to quit . The junior doctors are yet to determine their destiny with a 'Mexican Stand-off' against the government . The head of the regulatory authority has caused so much rage amongst GPs that even the Royal College and BMA dare not hesitate to go for his scalp. There is no peace in GP land and the young generation of doctors have poor impression of this government on how to handle NHS.
    (3) Poor Simon Stevens is trying to play the 'Messiah' but even deep down , he knows how hard and dire this situation is especially this project is truly contradicted by Osbourne's reckless obsession of reaching economic surplus by 2020 with the willingness to sacrifice all public services. I see some similarities between Stevens and Mark Carney , governor of Bank of England . The latter is really stuck as US federal government is now to raise interest rate and UK will be dragged into it ,but the average household spending power is in fact going down and down, hence poor rise in inflation to sustain a rise in interest rate. Thanks to the Chancellor, of course, who is only interested in large scale construction of infrastructures.The sound of hypocrisy is ringing everywhere .
    (4) The worst scenario of any government is losing the support of common people. It was funny when I talked to a best friend in London( he always vote for Tory) shortly after the general election , he said some of his colleagues were embarrassed to tell others they had voted for the conservatives. I suppose they had casted their votes with tears in their eyes? The most interesting irony is even their own ministers were turning against the cabinet. The calamity of building a third runway in Heathrow was catalysed when their London Mayor wannabe youngster literally 'put a gun' on Cameron's head blackmailing with a resignation. John Major's high profile objection of cutting the tax credit from backbench could not be ignored even by Osbourne.
    (5) Perhaps there is still some distance before becoming a 'lame-duck' government , our common enemy is showing 'cracks' everywhere and every inch of this battle is worth fighting , my comrades .......

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