The much anticipated “rescue package” for general practice has now been published and sets out plans to tackle historic underfunding, the recruitment crisis, red tape and unnecessary GP workloads, in a new document entitled the General Practice Forward View.
General Practice Forward View – the headline news
The headline news from this week’s General Practice Forward View package is that there will be an real-term increase in spending on general practice by 14% by 2020/21 – compared with 8% across the rest of the NHS.
This will mean that around 10% of the total NHS England healthcare budget will be devoted to general practice.
General Practice Forward View – what is means by 2020/21:
- Increase in general practice to increase from £9.6bn to £12bn per year
- 5,000 more doctors by 2020
- £900m spent on improving general practice facilities
- 5,000 additonal non-medical staff by 2020
- Reduction in the frequency of CQC inspections
- 10% of GPs’ time freed from red tape
- A paper free NHS
This week’s announcement comes after warnings from the profession that the future of general practice is at real risk of collapse, but has received a mixed response since its publication. A number of GP leaders have already backed the funding package, however, including RCGP chairwoman, Dr Maureen Baker, who said that this was the “most significant announcement for our profession since the 1960s” following the announcement.
In the following section of this article we take a look at an accountant’s perspective of the General Practice Forward View document and analyse the details behind the headline announcements.
General Practice Forward View – an accountant’s perspective
Scott Sanderson, Partner and Healthcare Specialist at Hawsons, welcomed the news, commenting: “The General Practice Forward View package represents a significant set of positive proposals to support general practice both now and in the longer term.”
“It’s no secret that the sector has been facing mounting pressures, heightened by unsustainable workloads, an unprecedented recruitment crisis and an unacceptable sustained decline in practice funding. Couple all of that with rising patient demand and it is clear to see why general practice has been in a parlous state for the last few years. The General Practice Forward View package is an acknowledgement of those challenges and proposes measures that are an initial step in the right direction.”
“The General Practice Forward View package will not solve all of the challenges facing general practice but it does set a new direction and mark a step-change for primary care. The majority of initiatives set out in the new package are what the profession has been asking for and they could even mark an important step for the sustainability of the entire UK healthcare system.”
“Many GPs will welcome the proposals but argue whether these measures really go far enough. What I would also say is, whilst the package’s proposals are a positive development, it will be the details that we do not yet know and the implementation of the measures that will facilitate a real change for GPs.”
There will be an real-term increase in spending on general practice by 14% by 2020/21 – compared with 8% across the rest of the NHS. Funding will rise by £2.4bn a year by 20/21.
This additional funding should give struggling practices the opportunity to invest more in staff and boost facility investment in order to deal with the overwhelming rise in patient demand.
It remains to be seen, however, how accessible the additional funding commitments will really be to practices given that none of it is going directly into core pay. It could be that a lot of the money with be tied up in red tape.
There continues to be strong opposition to how seven-day GP access will be serviced and funded but, with £500m of the recurrent funding set aside to improve GP access including “sufficient routine appointments at evenings and weekends” to meet local demand, it still remains very much on the NHS England agenda.
Targeting the recruitment crisis
The package unveiled a £206m funding structure to help meet the government target of recruiting an additional 5,000 GPs by 2020 and develop the wider primary care workforce, with 5,000 extra non-medical staff.
This includes increasing trainee places for new recruits, an international recruitment drive, plans to simplify return to work processes and major funding commitments for training and development of non-medical staff.
NHS England and general practice must still accept, however, that there remains a very long way to go to before they hit their ambitious recruitment targets of 5,000 new full time GPs by 2020.
Reducing the frequency of CQC inspections
One of the key measures proposed to reduce practice burden is to reduce the frequency of CQC inspections for GP practices and move to a ‘risk-based’ approach in the future. In addition to this, those practices that achieve ‘good’ or ‘outstanding’ CQC ratings will be inspected only once every five years.
Anything that reduces the amount of strain GPs are facing and the amount of red tape in the sector is welcome news, and the scaling back of CQC inspections is exactly that.
It will now be very interesting to see if there is a u-turn in the recent hike in CQC fee levels (CQC announced in December last year a significant increase to their fee levels), given that inspections will now cost much less to fund.
Forward View – the clue was in the name
Although there are a number of supportive measures that will come into effect over the next year, including significant additional funding and a reduction in the frequency of CQC inspections – that are of course all very welcome – the General Practice Forward View package is very much a blueprint for the future
However, general practice is under strain here and now; the sector is arguably in a state of emergency and many would have expected a greater focus on the immediate sustainable and stability of primary care.
Overall – tentative optimism for the future
With historic general practice underfunding you can understand some of the cynicism expressed by the profession at this week’s General Practice Forward View package. Many GPs are arguing that these measures simply do not go far enough.
But, whilst this is undoubtedly a belated package and will not solve all of the issues facing general practice, it is still a positive development for the sector and brings, at the very least, tentative optimism and hope for the future.
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