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NHSE target for practices to deliver ‘at or above’ pre-pandemic appointment levels


NHS England has published a new target for GP practices to deliver appointments ‘at or above’ pre-pandemic levels for 2021/22.

As part of achieving this target, practices should be ‘consolidating and maximising the use of digital consultation methods’, said NHS England.

The target is one of a set of metrics to be measured by CCGs and new ICS bodies, which are due to be taking over from CCGs from April 2022. It will see practices assessed on the number of available GP appointments as well as access to remote consultations.

In a new NHS System Oversight Framework for 2021/22 published last week, NHS England said that a ‘set of oversight metrics will be used by NHS England and NHS Improvement and ICSs to flag potential issues and prompt further investigation of support needs’ in local healthcare organisations.

An accompanying document listing the metrics set out a target for ‘all general practices to be delivering at, or above, pre-pandemic appointment levels, including through consolidating and maximising the use of digital consultation methods and technology’ in 2021/22.

It said that CCGs and ICSs will measure the ‘number of available appointments’ and the ‘proportion of the population with access to online GP consultations’ to assess this.

The framework added that ICSs will ‘co-ordinate any support and intervention carried out by NHS England and NHS Improvement, other than in exceptional circumstances’.

NHS England will ‘engage with the ICS before any escalation action/ intervention is finalised and enacted through a single identified system lead’, it said.

The document later said that a ‘key outcome’ of the framework will be ‘the early identification of emerging issues and concerns so that they can be addressed before they have a material impact or performance deteriorates further’.

Aside from routine monitoring, ICSs, trusts and commissioners are ‘expected to engage with regional teams on actual or prospective changes in performance or quality risks…where these are material to the delivery of safe and sustainable services’, it added.

PCNs and primary care providers will not be rated according to a new sliding scale featuring four ‘segments’ that takes into account CQC ratings – but the overall quality of their services will inform what rating their ICS and CCG are given.

The document outlined a wide range of metrics to be measured, including:

  • Patient experience of GP services
  • The restoration of elective and cancer services 
  • The number of people with a learning disability on the GP register receiving an annual health check
  • The proportion of staff who say they have personally experienced harassment, bullying or abuse at work over the last 12 months, including from patients, their relatives or other members of the public

It comes as the latest GP appointment figures demonstrated the ‘immense pressures’ GP practices are under, with practices in England carrying out 31.5 million recorded patient appointments in April.

NHS England last month issued guidance to practices that said GPs’ patients should be offered face-to-face appointments if that is their preference. The advice was contradicted by Public Health England guidance published around the same time that stated GP practices should use virtual consultation ‘where possible’.

Pulse reported earlier this month that NHSX and NHS England are considering the viability of a wider roll out of an artificial intelligence triage model based on that used by Babylon.

Meanwhile, GPs are awaiting the details of the planned Covid booster vaccination programme for this autumn, which NHS England’s chief executive has said will ‘very likely’ see Covid and flu jabs given together.


Vinci Ho 30 June, 2021 2:10 pm

The fundamental question is :
Exactly what the hell is ICS despite being described in a document full of rhetorics ?

Patrufini Duffy 30 June, 2021 2:44 pm

Er – Kanani-Waller et. al.
You speak like “pre-pandemic” was some sort of gold standard holy grail? It was an anxious, time-wasting mess. Which is returning with added privilege and aggression.
Fun in cookoo-land. What do you want next – smear uptake to 95% and antibiotic prescriptions to zero?

David Church 30 June, 2021 2:54 pm

They want more work out of GP Practiices.
I seem to recall BMA negotiating on a basis of ‘no more work wiothout new money’.
So, would NHSE like to confirm how much extra money GP practoices will be getting for the extra work, before they commit to taking on the extra staff?

Iain Chalmers 30 June, 2021 3:42 pm

No idea how they expect this piece of “crapology”

Come to think; since 1/2 time now and shrinking rapidly, don’t actually care.

See you all!!

John Graham Munro 30 June, 2021 4:02 pm

”Here comes your 19th. nervous breakdown”——–Rolling Stones circa 1966

David Jarvis 30 June, 2021 4:23 pm

Where in the contract is this? No number on consultations listed. Perhaps they would like to change to performance related pay.
But we can change tasks and admin stuff into consultations and hit their target rather easily whilst doing nothing more. They want to split hairs and micro manage but should be careful what they wish for.

Mark Howson 30 June, 2021 4:30 pm

The more and easier the access the more the demand increases. So it is a impossible to provided better access just by providing more access.
It is often bizarrely the opposite of what you might expect that might produce better outcomes. So I would advise reducing access and imposing simple barriers such as time when available or having a waiting list. Digital access reduces barriers and makes it too easy to consult with trivial problems. On the other hand it makes it easier to deal with non serious “urgent” problems efficiently- this needs more thought.
Streaming separately urgent cases and non-urgent cases. Our effective waiting list is usually only a few days. It is months in the prepandemic hospital and has been for years but not caused a problem.

Turn out The Lights 30 June, 2021 6:19 pm

The machine is broken,burnt out,good luck with trying to flog the camel with the broken back.Where is the BMA?

David Jarvis 30 June, 2021 6:58 pm

This i an NHSE target so next they need to work out how they are going to deliver it. If they want us to do it then they need to work out how they are going to manage that. I don’t care really. It is not my promise or ambition. They are idiots who I suspect actually have no clue how to do any of our job in any shape or form.

Chris GP 30 June, 2021 7:00 pm

“The proportion of staff who say they have personally experienced harassment,…”….from NHSE? All of us.
Where did the notion that tech consultations are quicker for us come from? It still takes the same amount of time , if not longer by the time the f***ing computer has crashed 3 times.

terry sullivan 30 June, 2021 8:50 pm

govt wants rid of gps

Turn out The Lights 30 June, 2021 9:47 pm

And they will get their wish.Will be sad watching an army of noctors sending patient round in ever decreasing circles sign posting them to other noctors.

Anony Mouse 30 June, 2021 11:27 pm

More beatings to improve morale

Patrufini Duffy 1 July, 2021 11:39 am

The waiting time for a Consultant is 16 weeks. No complaints there. The waiting time for a GP MUST BE SAME DAY. Remember most in NHSE don’t have more than 3 GCSEs – maths was too hard. You have 11 and you’re made to look dumb.

Andrew Jackson 1 July, 2021 11:40 am

There really is no long term plan for the future of primary care and the place of GPs in it.
It has now just come down to numbers of superficial transactions between a patient and some kind of health care professional.
No continuity, no important quality markers, no
listening to those who deliver primary care with the highest skill set.
There is no high quality career offer for young GPs anymore.
Leadership from the BMA and RCGP is so lacking.

Nathaniel Dixon 1 July, 2021 4:56 pm

NHSE and this government appear to have no long term vision – what they did have lies in tatters destroyed by the Mail and Telegraph, who actually seem to have the most say in long term NHS direction. To say I have no confidence in NHSE would be an understatement., there is clearly no leadership whatsoever. Can’t see there being enough GPs soon, anyone who can find a way out will.

John Glasspool 1 July, 2021 9:32 pm

Igonre them and they will go away.

James Weems 1 July, 2021 11:01 pm

Nowhere in the contract does it talk about appointment numbers. Sorry.

C Ovid 4 July, 2021 12:37 am

I think this will drive us out of the NHS: ask any ex-NHS dentist how that was managed. To paraphrase, it was a case of “destroying with faint support.”…
The NHS doesn’t recognise or deserve the added value we bring. It won’t come back once we have left. All that hard won training and experience: such a waste.

Patrufini Duffy 5 July, 2021 6:32 pm

Lets play this game then.
1 appointment = 1 referral = system crashes within 3 months.