The money, part of the overall £2.4bn a year increase for general practice, will help meet the government’s mandate for routine evening and weekend appointments for all patients in England by 2020, as well as access to out-of-hours and urgent care services.
The NHS England policy package said that the new funding would pay to meet locally determined demand.
CCGS and urgent and emergency care networks will commission new services building on the existing pilots funded from the £175m Prime Minister’s Challenge/GP Access Fund, which launched in 2014.
The services will work at-scale, enable self care and direct access to other services, make better use of the wider workforce such as nurses and care navigators and make greater use of IT to link patients to practices. The document also says the services could provide 'primary care access hubs' that would offer additional clinical capacity across a group of practices.
While local commissioners will be able to design the services, NHS England will set minimum requirements which will be tested in existing access pilots.
CCGs will also be asked to provide £171m of practice transformational support to stimulate development of at-scale providers.
NHS England said that the rollout of enhanced access would help reduce avoidable demand and reduce workload in general practice.
The GPC said NHS England had agreed that ‘no practice will be contractually required to be open beyond current hours’.
GP Forward View: Full coverage
The announcement of new central funding for access schemes came despite previous suggestions by the government that the roll out of extended access schemes would be funded from existing local commissioning budgets as they reduced A&E attendances.
Primary care minister Alistair Burt told GPonline in September 2015 that once the GP access fund pilot money ran out, the schemes would be ‘absorbed in the ebb and flow’ of existing funding.
The GPC has consistently criticised the lack of recurrent funding allocated to support the access schemes.
Speaking to GPonline ahead of the launch of the GP Forward View NHS England chief executive Simon Stevens said officials had taken a ‘realistic look at what will be required in order to be able to resource the expansion in GPs and other disciplines we want in primary care and back that with money’.
Mr Stevens said extended access schemes would not be self-funding, but would create downstream benefits for the rest of the health service.
‘We are not suggesting that would be self funding. We are suggesting there will need to be an expanded workforce and matched funding. But we are also saying that we think it will produce downstream benefits for the rest of the health service.
‘There is no great surprise that if you under-invest in primary care, pressures show up in other parts of the system. And it is unreasonable to ask GPs to take on more when they've not got the resource and backing to do it. But you've got 300 million plus GP consultations a year and 20 million A&E attendances, you only need very small changes in the availability of GP services for that to show up in other parts of the system.’
The GP Forward View said that the new voluntary multispecialty community provider (MCP) contract being developed for groups of practices to provide integrated, whole population, out of hospital care at scale, would be a ‘fundamental element’ of the plan.
The contract, details of which GPonline has revealed could be available as early as August, will go live in April 2017.
The contract will offer GPs independent contractor or salaried employment options, while blended quality and performance pay will replace CQUIN and QOF.
Moving off existing GMS or PMS contracts to new MCP arrangements will be voluntary, with MCP practices able to continue to hold dormant GMS or PMS contracts that can be reactivated, the GP Forward View says.
