Productivity scheme freeing GP time to focus on NHS transformation

A GP Forward View programme to improve practice productivity is being used to free up time for GPs to offer more appointments and take on work moved out of hospital, commissioners have said.

Practices in Bury, Greater Manchester are estimated to have saved more than 1,700 GP hours and 5,459 admin hours a year under NHS England’s Productive General Practice (PGP) programme.

The programme is funded nationally from the £30m ‘Releasing Time for Patients’ programme announced in the £2.4bn GP Forward View (GPFV) package in April 2016.

The RCGP said in its first annual assessment of the GPFV last week that 600 practices were participating in the PGP programme. Under the programme CCGs are provided with third party management consultants who work with practices on work flows and quality improvement.

GP workload

Practices can choose which of several areas they would like to focus on, including making better use of admin time, developing well organised practices, and more efficient processes.

Bury CCG’s deputy director of primary care Amy Lepiorz told GPonline that time saved in practices through the programme could be used to allow them to start making changes to the local health system required by the CCG.

‘We are trying to change the way the health system works locally,' said Ms Lepiorz. 'We need to give some support to the organisations to get that headspace to start thinking around these changes.’

The programme, she said, was about ‘how we can support them in freeing up that time so they can start to work differently and start to make some of the changes in Bury's health system'.

There had, she said, been a 15% increase in demand for GP appointments over four years, so practices had to change the way they work. ‘If you don't try to free up some time it's impossible for practices to make those changes that are needed,' she said.

Integrated care

Under its current five-year strategic plan, Bury CCG aims to develop an integrated care model with additional resources and demand redirected into primary care from the acute sector. The CCG is using GPFV funding to implement the Greater Manchester primary care standards specification which includes requirements for all practices to be open from 8am-6.30pm Monday to Friday, to offer a guaranteed 75 appointments per 1,000 patients per week, and offer same-day access to children under 12.

Ms Lepiorz said it was good to have outside consultants run the programme because they brought a fresh perspective. ‘We do things because that is the way we have always done things.'

The consultants - known as facilitators - while from a range of professional backgrounds, were 'all experts in quality improvement and introducing change', Ms Lepiorz said. 'Most of them were new to general practice, which we think is an advantage because it gives outside eyes to come in and challenge the status quo.'

Practice manager at St Gabriel's Medical Centre in Bury Ann Stewart added: 'Having a facilitator was really helpful. It was really focused and gave us a timeline of what he wanted us to do.


‘It kept the project on time and focused. It empowered the staff so they knew they were working with a third party and it gave them an opportunity to dissect the work they do every day.'

St Gabriel's worked over three months with their facilitator to analyse post and information coming into the practice and work out who was best to deal with it and how to do so more efficiently.

The GPs agreed which information they needed to see and the rest was dealt with by admin staff, saving four hours of GP time a week. The person responsible for recoding was given protected time and space for that work, halving the time it took to do it from 12 to six hours.

Ms Stewart said staff and GPs welcomed the initiative. 'They have more ownership. They have been able to tweak it to make it work for them and the practice,' she said. 'They were very enthusiastic about it.They felt more in control and understood it better. It has made them more receptive to changes ... because they have been empowered to have a voice and see changes made.'

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