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NHS England sets out measures to address GP workload


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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.

READERS' COMMENTS [7]

Douglas Callow 7 January, 2021 6:19 pm

This is very welcome news Better late than never ..

Patrufini Duffy 7 January, 2021 9:34 pm

Only when public and colleagues die, and cry, and feel avoidable suffering and pain did you want to open your eyes and help Primary Care almost 1 year on. Yes, we can move forward, we always do…we will clear the mud, not you NHSE.

Turn out The lights 8 January, 2021 6:48 am

How come this hasn’t been leaked to Tory propaganda rags on a Friday night so they can rip into us over the weekend Nikki?

John Glasspool 8 January, 2021 2:01 pm

ensure general practice remains fully and safely open for patients’, as well as ‘clearing the backlog of appointments’. Doesn’t sound like they are taking a great load off you, does it?

Andrew Jackson 9 January, 2021 12:09 pm

There probably is a desire to give us some breathing space but whenever people try and find something for us to stop doing it becomes clear our all you can eat buffet contract and funding does not allow us to meaningfully stop something that adds any genuine capacity.
We have calculated it will take 800 hours of GP time to deliver the portion of the vaccinations we anticipate we will likely be needed to deliver in the next 3 months
Our contract has no ability to remove this amount of work in a measurable way which is why we are unable to control work intensity.
Until this is possible within a working contract nothing will change.

David Riley 11 January, 2021 11:54 am

GPS are to be issued with new PPE consisting of a blue Lycra body suit, red cape and red pants to wear on top.

Hot Felon 13 January, 2021 7:21 pm

Haha since I left partnership 3 months ago, general practice has become a covid vaccination service!!
Vocational training, postgraduate exams, Roger Neighbour The Inner Consultation, all now consigned to the dustbin – so ‘yesterday’.
Nurses and paramedics and physician assistants now do our jobs after a training course.
Most of it is on the telephone.
What a sh1t job it has become!