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GPs to offer half-hour appointments as paramedics take on home visits



Exclusive GPs will be able to offer extended appointments that could last up to half an hour, after a group of local GP federations received £42m in funding from the GP Forward View.

According to GP leaders in Manchester, the funding injection has allowed general practice in the city to ‘breathe’ by paying for extended appointments and a wider clinical workforce in practices.

This includes hiring paramedics to take on nearly all home visits in the city, freeing up time for GPs to spend on patients with complex needs.

Dr Tracey Vell, chief executive of Manchester LMC, told Pulse that the extra funding ‘will make every GP have the capability to go to 20-30 minutes of quality, continuity-of-care appointments’.

Dr Vell added that with the extra time, GPs are able to spend longer with patients with complex needs, which she said is where continuity of care ‘really kicks in’. 

She said: ‘Continuity is less important for some populations, but what we are doing is giving patients that choice, we are not making it for them.

‘We are saying you can see your GP on this day, but if you don’t mind seeing any GP in a different setting on the same day, you could choose that.’

She added that the extended appointments scheme is ‘assisted by the time we save in not doing home visits, or not every home visit’.

Dr Vell said that some of the £42m was allocated for ‘additional workforce’, adding that some practices have access to ‘paramedics that are starting to do home visits for GPs’, while a clinical pharmacist is now stationed in every GP ‘hub’.

GPs in Manchester operate in hubs of up to six practices, covering between 30,000 and 50,000 patients each.

The hubs are divided into ‘local care organisations’ (LCOs), with between five and six hubs in each of 10 LCOs across Manchester.

One LCO went out to tender earlier this year for a 10-year contract worth £6bn to deliver all non-acute healthcare except core GMS contractual services to 600,000 patients.

This comes as Dr Robert Varnam, NHS England’s head of general practice development, told delegates at the RCGP’s Annual Conference that GPs have ‘chosen’ to work in 10-minute appointment slots, which he said is ‘unethical’.

Meanwhile, a review backed by the Chief Medical Officer found that a current average 9.2-minute GP appointment ‘does not give sufficient time’ to discuss treatment options.

Healthcare devolution in the ‘Northern Powerhouse’

Former Chancellor George Osborne announced two years ago that the NHS in Manchester  would become devolved from central Government, as part of the Government’s ‘Northern Powerhouse’ plans.

The deal saw the local authorities, alongside CCGs, given the freedom to jointly commission health and care as they pleased in the local economy.

Since then, in an even more far-reaching shake up, NHS England has unveiled plans to devolve responsibility for commissioning to care organisations themselves.

This will see, in the long run, all of a current 44 Sustainability and Transformation Plan (STP) areas become ‘accountable care systems’ in future.

NHS England has named Greater Manchester as one of nine ‘likely candidates’ to become one of the first such ACSs.

In return for becoming an ACS, NHS England has promised the organisations ‘more control and freedom’ over their regional NHS including receiving devolved national GP Forward View, mental health and cancer funding from 2018.