London GPs face contract overhaul and routine Saturday opening

Plans to overhaul primary care in London could see GP funding no longer offered at individual practice level, but to large providers or groups of practices 'through a new contract at a wider population level'.

London: GPs face Saturday opening and contract overhaul (Photo: Julian Dodd)
London: GPs face Saturday opening and contract overhaul (Photo: Julian Dodd)

All practices across the capital would be required to offer pre-bookable, routine appointments between 8am and 6.30pm Monday to Friday, and from 8am to noon on Saturdays.

GP contracts would be shifted from GMS/PMS deals to either an APMS, NHS standard contract or hybrid model. The deal would mean practices across large groups share QOF incentives and enhanced services funding and pool a proportion of core practice funding.

The plans, set out in a report from NHS England's London region, Transforming Primary Care in London, also envisions patients having access within 24 hours to a GP or nurse 'at the practice at which they are registered'.

Read more: Londonwide LMCs reaction

Meanwhile, networks of practices working together would ensure all patients have access to a GP or primary care professional seven days a week from 8am to 8pm.

The plans would shift around an extra 1% of the existing London health budget into primary care each year for five years to boost funding by up to £800m.

The report sets out a vision for a 'new deal for general practice'. It plans to stabilise GP funding for two years while a review looks at how to ensure different areas receive fair shares of funding.

The plans would also shift more control of NHS budgets to CCGs, build GP numbers through recruitment and retention schemes and draw on the £150m Challenge Fund and £250m-a-year infrastructure funding streams to expand primary care infrastructure and services.

Vision for general practice

It maps out plan to deliver 'an ambitious and attractive vision of general practice that operates without borders, and in partnership with the wider health and care system'.

Primary care would become more proactive, accessible and co-ordinated under the vision set out in the NHS London report. More proactive care would aim to reduce health inequalities by targeting care better at patients who need most support.

The report says: 'This care might be delivered across a group of practices by a team comprising roles such as care navigators, peer advocates, health coaches, wellbeing support workers and community volunteers. Reducing health inequalities is not just about focusing on illness, but providing a holistic response to social issues like debt, housing, employment and substance misuse to improve health and wellbeing.'

Better co-ordinated care would involve practices identifying patients who could benefit from having a care plan developed to shape their care, delivered by a range of health and social care professionals.

The model set out in the document could 'only be delivered by primary care teams working in new ways and by practices forming larger primary care organisations', it says. The report adds: 'These organisations will need to be aligned to a shared geography in support of a population health model with other health, social, mental health, community and voluntary organisations. How this looks will differ from area to area and will be designed and owned locally.'

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