New recurrent funding will be rolled out to the whole of England as part of the implementation of the GP Forward View.
From this year the funding will be handed to areas running GP Access Fund pilots and expanded to include additional areas in 2017/18, new planning guidance from NHS England and NHS Improvement confirmed.
‘The investment will be extended in 2018/19 to enable the whole country to start developing additional capacity, so that from April 2019 every CCG can expect a minimum additional £6 per head to improve access to general practice’, the bodies said in a statement.
NHS England’s director of primary care Arvind Madan, said: ‘We know that general practice is under pressure and we are determined to maintain the momentum in turning things around, as started with the launch of the GP Forward View. Today’s planning guidance, with detail on how investment will look in the coming years, demonstrates the steps we will be taking with CCGs to both stabilise and transform GP services in the years to come, for the benefit of staff and patients.’
GP leaders welcomed the publication of the guidance. GPC deputy chairman Dr Richard Vautrey said NHS England appeared to have learned the lessons of the GP Access pilots with no requirment for 8am-8pm weekend appointments and flexibility for local needs. But, he warned, the £6 per patient funding was 'considerably less' than schemes had previously received, so commissioners would 'need to cut their cloth according to this reduction'.
The guidance orders CCGs to draw up plans to implement local elements of the GP Forward View. Local commissioners have until 23 December 2016 to submit their plans.
CCGs will have to show how they will create and deploy local elements of the new funding promised in the GP Forward View published in April.
The GP Forward View promised a £500m sustainability and transformation package on top of increased recurrent funding.
CCGs have been told in the new guidance to set aside £3 per head from their core service allocation as a non-recurrent investment over two years from 2017/18 to fund a £171m practice transformational support fund promised in the GP Forward View.
The funding will be used to stimulate at-scale provider development for improved access, stimulate implementation of actions to free up GP time and to secure the sustainability of general practice.
CCGs will be allocated £15m in 2017/18 and £20m in 2018/19 of a £45m three-year fund for GP consultation software. Commissioners will have to deliver a national specification.
A package of £45m to train care navigators and medical assistants for all practices will be devolved to CCGs over five years, with £5m allocated this year, £10m in 2017/18 and 2018/19.
GP Forward View plans will also set out how CCGs will deploy funding for reception and clerical staff training, plan to support the Time to Care programme for releasing GP capacity, and draw up local general prcactice workforce strategies
CCG funding to general practice is also expected to rise by an amount equivalent to CCGs’ overall allocation increase, 2.14% in 2017/18, and 2.15% in 2018/19.
In order to get the additional recurrent funding for improved GP access services CCGs will be required to commission:
- an additional 1.5 days worth of pre-bookable and same day evening appointments
- Saturday and Sunday appointment
- A minimum additional 30 minutes consultation capacity per 1,00 population, rising to 45 minutes
- Automatic measurement of appointment activity in all participating practices
- Patients should be offered a choice of evening and weekend appointments on an equal footing to core hours appointments
The guidance said the the additional appointments can be provided on a hub basis.
Dr Vautrey said: 'It's helpful that NHS England have finally confirmed arrangements for some of the key elements of the GP Forward View, including a commitment to recurrent funding, and that they have been explicit that strengthening general practice must be a central part of local STP plans. This is vital at a time when general practice is overwhelmed by unsustainable workload pressures leading to GP burnout and practice closures. CCGs must now work with their practices to ensure that all commitments made in the GP Forward View are delivered.
He added: 'It appears that NHS England have learnt from the lessons of many of the pilots which showed that there was little demand from patients for routine weekend appointments. There is importantly now no requirement to be open 8am-8pm on Saturdays and Sundays, with flexibility based on local needs. It is sensible that extended hours appointments will also be available for urgent appointments.
'The £6 per patient recurrent funding for CCGs with current prime minister's Challenge Fund sites is considerably less than many have received previously, so they will now need to cut their cloth according to this reduction in funding. With a shortage of GPs and reduced funding they will also have to consider using other health professionals to provide these appointments. In addition we would expect CCGs to work with GPs to integrate current out of hours and urgent care services to avoid duplication and make best use of the available resource.'