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Five-year plan for general practice unveiled

14% funding rise for primary care by 2020

Adrian O'Dowd

Thursday, 21 April 2016

A multi-billion pound backed plan to get general practice “back on its feet” is being launched today by NHS England.

The General Practice Forward View report, developed with Health Education England and in discussion with the RCGP and other GP representatives, sets out a blueprint for the country’s GP service over the next five years.

It will be backed by an extra £2.4 billion a year for general practice services by 2020-21, meaning a 14% real-terms increase from £9.6 billion in 2016-17 to more than £12 billion by 2021, although this is not new money and is part of a settlement agreed with the Treasury in last year’s spending review.

NHS England said it planned to double the growth rate in GPs, through new incentives for training, recruitment, retention and return to practice.

The plan is to increase GP training recruitment to 3,250 a year to support an overall net growth of 5,000 extra doctors by 2020 (compared with 2014).

To achieve this, several steps will be taken including:

  • major recruitment campaign in England to attract doctors to become GPs, supported by 35 national ambassadors and advocates
  • new international recruitment campaign to attract up to an extra 500 appropriately trained and qualified doctors from overseas
  • targeted £20,000 bursaries in the areas that have found it hardest to recruit into GP training
  • 250 new post-certificate of completion of training (CCT) fellowships to provide further training opportunities in areas of poorest GP recruitment
  • attract and retain at least an extra 500 GPs back into English general practice through simplifying the return to work routes.

Primary care will also be boosted by 3,000 new fully funded practice-based mental health therapists, an extra 1,500 co-funded practice clinical pharmacists, and nationally funded support for practice nurses, physician assistants, practice managers and receptionists.

The extra money for general practice will be supplemented by a £508 million national 'turnaround' package to support GP practices, and additional funds from local CCGs.

In addition to more money, the plan contains specific, practical steps to strengthen workforce, drive efficiencies in workload, modernise infrastructure and technology, and redesign the way modern primary care is offered to patients.

A new practice resilience programme to support struggling practices will be created as well as changes to streamline the Care Quality Commission (CQC) inspection regime so surgeries rated ‘good’ or ‘outstanding’ by the CQC will only be inspected every five years.

Support for GPs suffering from burnout and stress is promised in the form of £16 million extra investment in a national specialist mental health service being set up to support these GPs. The service is due to be operational from December.

The report also promises cuts in red-tape, legal limits on administrative burdens at the hospital/GP interface, and action to cut inappropriate demand on general practice.

NHS England chief executive Simon Stevens said: “GPs are by far the largest branch of British medicine, and as a recent British Medical Journal headline put it – if general practice fails, the whole NHS fails.

“So if anyone 10 years ago had said: ‘Here’s what the NHS should now do - cut the share of funding for primary care and grow the number of hospital specialists three times faster than GPs’, they’d have been laughed out of court. But looking back over a decade, that’s exactly what’s happened.

“Which is why it’s no great surprise that a recent international survey revealed British GPs are under far greater pressure than their counterparts, with rising workload matched by growing patient concerns about convenient access. So rather than ignore these real pressures, the NHS has at last begun openly acknowledging them. Now we need to act, and this plan sets out exactly how.”

Both the RCGP and BMA welcomed the plan and Dr Maureen Baker, RCGP chair, said: “This is the most significant announcement for our profession since the 1960s.

“For too long GPs - and our members - have been undervalued, underfunded, and not recognised for the essential role we play in keeping the health service sustainable and safe for patients. We genuinely hope that today's news marks a turning point for general practice. Today’s announcement is a huge and important step in the right direction.”

BMA GP committee chair Dr Chaand Nagpaul said: “The General Practice Forward View represents a significant and comprehensive package of proposals to support general practice both in the immediate and longer term, the most that we have seen since 2004.

“Crucially, NHS England have committed to investment which will reverse the unacceptable decline in general practice funding. It is vital that GPs and staff see tangible delivery against these commitments, so that the words are translated into action.”

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