In a letter to the BMA's GP leadership, NHS England's national director for primary care Ian Dodge recognised 'intense' pressure on general practice - acknowledging that the profession is 'working harder than at any time in its history'.
Mr Dodge acknowledged that practices were working 'flat out' in their response to pressure intensified by the COVID-19 pandemic, and paid tribute to practices delivering more appointments than before the pandemic even before the millions of contacts as part of the vaccination campaign are factored in.
The NHS primary care director also recognised the remarkable achievement of practices in securing an increase in patient satisfaction across a broad swathe of measures amid the intense workload pressure.
NHS England is considering steps to ease pressure on general practice through 'different phasing of PCN service specifications', the letter confirmed.
'NHS England is looking again at whether certain of these can be deferred from this October until no later than April 2022, bearing in mind the renewed urgency of tackling healthcare inequalities for example in hypertension detection, working in tandem with our community pharmacy partners,' the letter said.
It added that given current pressure on general practice, 'the main implementation focus of the PCN Investment and Impact Fund should be 2022/23 rather than 2021/22, so that PCNs have maximum possible time to prepare'.
The letter added: 'NHS England must also honour the existing commitment to expanding the 2021/22 Fund up to the £150m of promised available funding, as a lead-in to the £225m 2022/23 Fund. We also agreed that NHS England should aim to provide clarity on both the rest of the 2021/22 IIF and at the same time the 2022/23 IIF as soon as possible.'
The letter also sets out NHS England's hopes to restore formal talks with the BMA GP committee (GPC). Talks have been suspended since May, when demands over face-to-face appointments triggered a vote of no confidence in NHS England's leadership by the GPC.
Talks could only be restored if the move is approved by a fresh GPC vote, at which GPC members would need to agree 'that sufficient steps have been taken to restore the committee’s confidence in the executive directors of NHS England'.
The letter from Mr Dodge said both he and new NHS England chief executive Amanda Pritchard had 'affirmed the value we place on our relationship and dialogue with you and GPC England.
'We have shared objectives of supporting the sustainability of general practice and improving services and outcomes for patients. The primary care team here stands ready to resume working with you, including on PCN extended access arrangements, as soon as you may be able.'
The NHS England letter also acknowledged plans to boost the general practice workforce through recruitment via PCNs, and acknowledged 'the need to reinvigorate efforts to drive more systematic uptake of GP recruitment and retention initiatives'.
Responding to the letter, BMA GP committee chair Dr Richard Vautrey said: 'GPs and their teams have been working immensely hard over the last 18 months, going above and beyond during the pandemic, delivering record numbers of appointments both remotely and face-to-face, all on top of existing pressures and an historic vaccine rollout, and it’s encouraging to see this acknowledged in today’s letter from NHS England.
'Following the constructive meeting with the newly appointed NHS England and Improvement chief executive, Amanda Pritchard, last week, these are further welcome steps from NHS England, and suggests a change in tone, understanding and approach. We are keen to build on this and turn this into positive action so we can both reform our working relationship and work together for the good of practices and our patients.'