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NHS England announces pilots around ‘new ways of working in general practice’

NHS England announces pilots around ‘new ways of working in general practice’

ICBs will test new ways of using ‘more flexible staffing models’, data and process automation within general practice in a pilot scheme that could change the way the profession works, NHS England has announced.

A letter sent to integrated care boards today stated that seven ICBs, led by Suffolk and North East Essex ICB, will formulate new ways of working within general practice.

This will ‘further deliver’ on 2022 report by GP and NHS national medical director for primary care Dr Claire Fuller.

The letter doesn’t go into detail about what the pilots will entail for GP practices, but does say ICBs should work with primary care networks.

Pulse has reported on ICBs putting forward plans to separate same-day access from general practice, leaving practices with responsibility for routine appointments only, which they have claimed is in line with the Fuller report.

These new pilots will shape how the Fuller report is implemented more widely, however.

The Fuller stocktake, a landmark review on integrating primary care with other NHS services, recommended that GP practices form ‘single urgent care teams’ across ‘neighbourhoods’ to improve patient access.

It also laid out plans to develop ‘innovative employment models such as joint appointments and rotational models’ to counter the GP workforce crisis.

The letter stated that the specific aims of the pilots would be to:

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  • Improve insight and data by ‘testing more flexible staffing models and ways of reducing administrative burdens’;
  • Understand what is needed to ‘deliver the Fuller Stocktake vision consistently and sustainably’;
  • Evaluate the use of ‘digital tools such as process automation and risk stratification’ to support GP teams
  • Use ‘dedicated multi-disciplinary teams’ to support patients with more complex needs’

It added that these insights would be collected over a ‘two-year timeframe’.

Earlier this year, North West London ICB caused controversy with its plans to integrate a hub model, based out of PCNs or groups of PCNs, aimed to ‘deliver a single point of triage for same-day, low complexity’ demand for all 2.1 million residents within the integrated care system, leaving GP practices with only longer-term, ‘complex’ care.

The CEO of the ICB suggested that these plans were in line with the Fuller report, claiming that ‘some aspects’ were ‘determined nationally’.

NHS England distanced themselves from the plans, stating that it was up to the commissioners to implement the Fuller report based on local circumstances.

In response to the announcement of new pilots, the BMA’s GP Committee argued that the way to ‘better optimise’ general practice is to provide ‘more funding for the existing operating model’.

Deputy chair Dr David Wrigley said: ‘Rather than attempting new, untried and untested ways of working in general practice, we should be concentrating on ensuring that patients can see their family doctor quickly and easily, in a practice that is local to them, which is well-staffed and resourced, and safe.’

He said that during recent negotiations with the Government, the BMA sought to highlight the erosion of £600m investment from the GP contract – but this ‘fell on deaf ears’.

Dr Wrigley continued: ‘Our evidence also included how this was forcing practices to reduce staffing, particularly GPs and nurses, as well as to seriously consider closing their doors for good.

‘We must invest to reverse the exodus of doctors we’ve seen in general practice over the last decade, and support GPs a to meet increasing demand and complexity of urgent and proactive care.’



Please note, only GPs are permitted to add comments to articles

David Jenner 2 May, 2024 2:46 pm

Suggest non cooperation with these pilots until a reasonable financial contract uplift has been agreed. As they are not statuary, non cooperation would not seem to constitute industrial acrtion in my understanding

Douglas Callow 2 May, 2024 3:43 pm

HMG no money
Doesn’t really value general practice
Fuller = agenda to have ”primary care” run by ARRS and in time run/controlled/responsibility of PCNs
If ICBs had salaried model they-HMG would be responsible for outcome metrics and to public
This way not their problem

Darren Tymens 2 May, 2024 3:50 pm

It is not GMS. It is not core. It is not obligatory. I would suggest a polite ‘no’, followed by an impolite ‘no’ if necessary.
But beware: I bet there will be a big financial carrot initially (which wil be followed by a Big Stick in due course) in order to lure in ambitious PCN CDs.
This is a Trojan Horse for getting General Practice to devolve into taking responsibility for delivering cut-price urgent care (delivered by ARRS staff ‘supervised’ by doctors), paid for by robbing practices of their core funding and leaving Practices with a rump of underfunded, unsustainable workload consiting almost exclusively of complex health conditions.

Centreground Centreground 2 May, 2024 4:16 pm

PCN Clinical Directors in return for money, PCNs , ICBs ,ICB staff in return for excessive remuneration, NHSE staff with no direct responsibility for frontline patient care and the government are aligned in their perverse desire to have destroyed and reckless desire to continue to destroy a previously highly effective Primary Care System prior to their catastrophic interventions.
They remain accountable for an incalculable increase in unnecessary deaths and morbidity due to their combined staggering incompetence in the management of NHS resources.

Sal Kal 2 May, 2024 4:30 pm

We need to get NHS England and this government to get their methods out of way at every level. Seeing the ARRS function and persistent attempts to shape things in new ways under Fuller report is way to quietly make NHS viable financially for private operators . It is false efficiency- cheap at service delivery point but financial disaster for NHS . Secondary care and patients.Injury nurses cannot do visits, pharmacists cannot triage elderly with abdominal pain , physio wil not improve back pain. Stone etc but that is what is happening . These guys are going beserk.

Neil Tallant 2 May, 2024 6:07 pm

How many times does the merry-go-round have to turn? “New ways of working?” Haven’t we heard this before or have we all got dementia? Good luck…

Simmering Frog 2 May, 2024 9:28 pm

I think this is a good idea. Instead of rolling out untested policy nationwide, do some trials first. However, the resources must be the same for any wider rollout and any assessment must be done scientifically/neutrally.

So the bird flew away 2 May, 2024 10:43 pm

This move like others recently is not about improving general practice, but disrupting and destroying it.
Funny how MPs “way of working” has remained more or less unchanged for nigh on a century..

David Church 3 May, 2024 7:47 am

Contra Simmering Frog, this might have been a good idea a decade ago, so that we had evidence on which to base the wholescale introduction of these ‘new models’ now; but it is too late now to run ‘pilot trials’ as the outcome has already been decided.
This is just s trick to sign up more practices to the ‘new models’ in order to dismantle proper Generl Practice, by a sick government who prefer to kill their population by long waiting lists and withdrawing access to qualified GPs; and to sell arms for personal favours to other countries, than to stop wars and help refugees.

Some Bloke 3 May, 2024 9:41 am

clearly we do not have mutually respectful and trusting relationship with our lords and masters at NHSE

Carrick Richards 3 May, 2024 1:23 pm

NHS reform without stakeholder engagment. Not any more likely to improve NHS managment techniques?

Dr Jeffries 3 May, 2024 5:22 pm

How about ICB just stop working all together. Bring back FHSA and an updated red book. It worked, GPs were happy, patients were happy and care happened.

paul cundy 5 May, 2024 8:22 am

Dear All,
This is not about “new” ways of working, they’ve all bee tried and failed in the past, its about a new set of suit wearing 12 year olds who’ve just been promoted in NHSE. Lions expectantly led by Donkeys.
Paul C

Finola ONeill 8 May, 2024 12:42 pm

Darren Tymens, exactly correct. GP partners; Just say no.