NHS England sets out measures to address GP workload

NHS England has set out a range of measures in a bid to address GP workload in the coming months, including the suspension of local enhanced services and QOF income protection.

A letter sent out today by medical director for primary care Dr Nikki Kanani also said that GPs could decline appraisals during this period of the pandemic.

NHS England will quadruple funding for PCN clinical directors from January until March, from 0.25 whole time equivalent to 1 WTE in recognition of the workload involved with the vaccination programme.

However, the letter also said GPs should ‘ensure general practice remains fully and safely open for patients’, as well as ‘clearing the backlog of appointments’.

Pulse reported this morning that NHS England had GPs should continue delivering services ‘as normal’ while a review into guidance on how to prioritise Covid vaccinations and manage pressures was ongoing.

The review, published this evening, set out measures for CCGs designed to address GP workload. They included:

• Suspension of locally commissioned services, except ‘where these are specifically in support of vaccination’ or other Covid-related support, including reducing admissions;
• A review of whether clinical CCG management could support practices or PCN work;
• To take a ‘supportive and pragmatic approach’ to GP contract enforcement across routine care.

It also said that any PCN where ‘at least one practice’ is participating in the Covid vaccination scheme will receive increased funding for their PCN clinical director, meaning they will receive 72p per patient in the first quarter of this year.

Other measures designed to reduce workload include:

• The Quality Improvement domain within QOF will be protected in full at 74 points per practice until March 2021;
• The Minor Surgery DES income will be protected until March 2021.
• GPs can decline appraisals and, if they decide to go ahead, the ‘revised, shortened, supportive 2020 model’ should be used.

However, at the same time, NHS England laid out a number of areas that GPs should prioritise, ‘supported through the COVID-19 Capacity Expansion Fund’. These were set out in the letter send out in November 2020 and include:

• Ensuring general practice ‘remains fully and safely open for patients’, including maintenance of appointments.
• Supporting establishment of the simple COVID oximetry@home patient self-monitoring model and identifying and supporting patients with Long COVID.
• Continuing to support clinically extremely vulnerable patients and maintaining the shielding list.
• And ‘continuing to make inroads into the backlog of appointments’. This includes chronic disease management and routine vaccinations and immunisations.
• Make ‘significant progress’ on learning disability health checks and ethnicity recording.

Last week, NHS England pledged to ‘remove unnecessary contractual burdens’ in a bid to free up time for practices to focus on Covid vaccinations.

And a slide presented at NHS England’s latest GP webinar on Tuesday evening said: ‘Primary care services should continue as normal, although we are also currently reviewing guidance and contracts to support prioritisation of activity in primary care, given the multiple pressures, and will share an update this week.’

‘Some regions have already begun to set out reprioritisation in their areas’, it added.

Pulse revealed yesterday that GPs in London have been asked to ‘stand down’ routine work over the next two weeks and ‘focus on urgent care’, including support for care homes.