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General Practice Forward View (GPFV): Breakdown

NHS England has unveiled its General Practice Forward View (GPFV) support package for general practice, with plans for developing the practice workforce and how it intends to meet government targets to recruit 5,000 GPs by 2020.

Here’s a summary of the proposals in the 60-page document:

Workforce

  • Increase in GP training recruitment to 3,250 a year

  • Major recruitment campaign in England for GPs

  • Major International recruitment to attract up to an extra 500 overseas doctors

  • £20k bursaries to entice GPs in hard-to-recruit areas

  • Attract (and retain) extra 500 GPs BACK INTO general practice (following RCGP report)

  • Increase financial compensation through GP retainer scheme from 1st May 2016

  • Introduce new fit-for-purpose GP Retainer scheme from April 2017

  • 5,000 other staff working in general practice by 2020/2021. This will include;
    - 3,000 mental health therapists
    - Extend current pharmacist plans (470 clinical pharmacists in over 700 practices) to one pharmacist per 30k population (extra investment of £112m)
    -New pharmacy Integration Fund

  • General Practice Nurse Development Strategy - £15m to;
    - Improve training capacity
    - Increase number of pre-registration nurse placements
    - Improve nurse retention
    - Support Return to Work schemes for Nurses
  • £45m (nationally over FIVE years) for reception/Admin staff training ('Care Navigation')

  • Training 1,000 ‘Physician Associates’ for General Practice

  • Pilot – ‘Medical Assistant’ to support GPS (recommended by RCGP)

  • £6million in Practice Manager Development, alongside access for PMs to new national development programme

  • £3.5m in mutli-disciplinary training hubs to support wider workforce development

  • Set more indicative rates for locum staff – practices will identify annually where they have had to pay over the odds

Health and wellbeing

  • £16 million extra investment in specialist mental health services to support GPs suffering with burn out and stress, and support retention of GPs

  • More measures to give GPs flexible working options, instead of going to locum work

Workload

  • Major £30 million ‘Releasing Time for Patients’ development programme to help release capacity within general practice

  • New standard contract measures for hospitals to stop work shifting at hospital/practice referral points
    - 27 percent of appointments could potentially be avoided if there was more coordinated working between GPs and hospitals, wider use of primary care staff, better use of technology to streamline administrative burdens, and wider system changes.
  • New 4-year “Practice Resilience Programme” starting in 2016

  • Good & outstanding Practices will not be inspected for another 5 years

  • Streamlining payments processes for practices

  • More automation of common Practice tasks

  • Introduce a more simplified system across NHS England, CQC and GMC.

Other

  • September 2016, a national programme to help practices support people living with long term conditions to self-care

  • New standards for outpatient appointments and interactions with other providers
    - Local Access policies
    - Onward Referrals
    - Discharge Summaries
    - Outpatient clinic letters
    - Results & treatments
    - Medication on discharge
  • Successor to QOF – NHS England to review with GPC in 2016/17
    - For practices opting in to the proposed new voluntary MCP contract QOF will be replaced with more holistic team-based funding
  • Streamlining Reporting requirements and payment system

  • Speeding up the “paper-free” Practice by 2020
    - By 2020 all incoming clinical correspondence from other NHS Providers is electronic and coded
    - Reduces workload and risks of errors in data entry
    - More seamless patient care
  • Review Mandatory Training in general practice

Practice infrastructure

  • NHS England to invest up to £900m in practice estates and infrastructure over 5 years

  • NHS England to fund up to 100% of premises development costs

  • NHS propose to fund Stamp Duty Land tax for leases from May 2016 to end of October 2017
    - Compensate VAT where charged by landlord
    - Applies to practices who are tenants of NHS Property Services
  • ‘Transitional funding support’ for practices that had a significant rise in facilities management costs in next 18 months for leases held with NHS Property Services and Community Health Partnerships

  • Investment in better technology in patient care – records, payments, prescribing etc.

  • GP IT Services through CCG-controlled GPIT budget
    - Ability for GPs to access digital patient records on/off-site (e.g. home visits)
    - Specialist support for IG, IT security, data quality, systems training and others
    - Outbound SMS from practice to practice for direct patient clinical communication
    - Patients get better appointments booking, repeat prescriptions and records access
    - Aim is for 10% patients to be using one or more online services by end of 2016
  • Discharge letters to be sent directly into GP clinical systems from June 2016

  • Specialist advice on Information Sharing agreements available from December 2016

  • Funding for WiFi within Practices from 2017

  • Access data on patient demand to allow adequate resourcing and delivery of practice services from June 2017

  • National Framework for purchasing phones and e-consultation tools from December 2017

  • Funding for education & support for patients & practitioners to use digital services better from Dec 2017

  • Digital pathways to join different healthcare sectors and professional groups

  • Increase EPS uptake

  • Support Federated practices by integrated appointment bookings (e.g. book from one practice to attend at another)

Care redesign

  • £500 million of recurrent funding by 2020/21 for commissioning and funding of services to provide extra primary care capacity across every part of England

  • Integrate extended access with OOH and Urgent Care services
    - Includes a reform of 111 and local Clinical Hubs?
    - Evening & weekend appointments to meet local demand
    - Enable self-care and direct access to other services (e.g. online self-management, signposting to other services)
    - Better use of ANPs, clinical pharmacists, physios and medical assistants
    - More use of digital technology (e.g. apps, phone consults, webcam links)
  • One-off investment of £171m by CCGs starting 2017/18 for 'practice transformational support'

  • 'Multi-speciality Community Provider' contract from April 2017 to integrate General Practice services with Community & wider healthcare services.
    - MCP defined as an integrated provider not a form of practice based commissioning or total purchasing.
    - It's scope is the services it will itself be providing, not all acute and specialised services
  • Fund local collaboratives to support Practices to implement new ways of working

  • Provide free training & coaching for clinicians and managers to support practice redesign

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