'Time for Care' to be extended across the NHS
Author: Mark Gould
An NHS scheme that has enabled GP practices to free up more than half a million hours of time for patients is to be extended following a successful pilot.
NHS England said the Time for Care scheme, which has been undergoing trials since 2016, should be in place in three-quarters of GP practices by 2022. The scheme encourages practices to try innovations to cut bureaucracy.
In 2018, 205,157 clinical hours - equivalent to GPs having 1.2 million more appointment slots - were freed up by the scheme. NHS England said that represents close to £40m in time saved, as the average cost of an appointment is £30. The scheme also saved 330,096 administration hours in the past year.
Dr Nikita Kanani, NHS England's medical director for primary care and a south-east London GP, said the programme has had "significant benefits for patients and GPs alike, freeing up doctors' time and NHS resources to ensure people get the care they need as quickly as possible.
"GP services will continue to be at the heart of our health service, and it makes sense to invest for another three years in a programme that is delivering so much for patients while helping us to be more efficient."
Routine GP appointment waiting times were reduced by 47% at Pickering Medical Practice in North Yorkshire after it took part in the scheme. The surgery had an average waiting time of 19 days, which led to a greater demand for urgent appointments, as patients' conditions worsened during the time they had to wait.
Staff reported high levels of stress as there were high levels of patient complaints due to the long waiting time. After a staff suggestion, patients are now offered a telephone appointment first, leading to a 12% increase in telephone appointments. This has reduced the number of patients seeing a GP face-to-face by 8%. As patients are able to get the attention of a GP sooner, the demand for urgent care consultations has fallen from 48% of the total to 37%.
They also freed up GPs' time by appointing a clinical pharmacist to deal with medication tasks and recruited a new nurse practitioner to increase the number of nurse appointments available.
Helena Ebbs, a GP at the practice, said she was "proud" of the changes they'd made. She said it has "had a great impact on patients" and "energised" her "enthusiasm in a time of great pressure".
Dr Richard Vautrey, BMA GP committee chairman, said the extension of the scheme was "welcome" as there was potential for the scheme to go much further "with practices considering safe, effective automation within their systems in order to free up staff time and release time for care".
But he said "much more needs to be done to reduce the day-to-day pressures on practices so that we can make general practice a positive environment for all staff to work in.
"Unsustainable workload pressures have been the number one concern for many GPs and their practice teams in recent years, and have been a main cause of the recruitment and retention crisis in general practice."
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "NHS England's evaluation of the Time for Care programme suggests it is making a real difference to some GP practices, and it is reassuring to know that NHS England are listening to our concerns about GP workload and taking action to help tackle this.
"However, most of our hard-working, hard-pressed GPs will still tell a different story of working longer and longer hours and seeing more patients per day to try and cope with demand, which continues to increase in both volume and complexity.
"The impact of Time for Care has to be seen as just one part of a much bigger solution that is needed."