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.’