Patients urged to ‘self-manage’ conditions as part of major shake-up of GP surgeries

By The Press Association21st April 2016News EnglandGPs, Health and Wellbeing, News England, NHS, Primary Care / GP's

Patients will be urged to “self-manage” conditions online and see nurses and pharmacists as part of a major shake-up of GP surgeries.

NHS England has announced a five-year plan to put general practice “back on its feet”, with an extra £2.4 billion a year in funding by 2020/21.

The boost comes after mounting pressure from GP leaders over increasing workloads and underfunding, as well as a shortage of trainee doctors willing to go into general practice.

Under the plan announced by NHS England boss Simon Stevens, GP practices will work together to manage patient demand, increase their opening hours on week nights and weekends and encourage patients to see professionals other than GPs.

It calls for a reduced burden on GPs while “increasing the role” of other practitioners and better “self-care” among patients.

It said examples would include “online self-management and signposting to other services, better use of the talents in the wider workforce, such as advanced nurse practitioners, clinical pharmacists, care navigators, physiotherapists and medical assistants, and greater use of digital technology, for example, apps connecting patients to their practice (and) phone and email consultations.”

The plan said there would be investment in “online resources that will help patients self-manage, for example, more self-help content on NHS Choices, online consultations and 111 Online, which is currently in development.”

GP practices could see an extra 1,500 pharmacists working alongside them to streamline things such as repeat prescriptions, deal with minor ailments and help people with long-term conditions. There is also a plan to bring 3,000 mental health therapists into primary care.

Some £45 million has also been earmarked “so that every practice in the country can help their reception and clerical staff play a greater role in care navigation, signposting patients and handling clinical paperwork to free up GP time.”

Overall, an extra 5,000 non-medical staff are needed over the next five years to support general practice, alongside 5,000 more GPs. There will also be a push to retain existing GPs and those who want to work flexibly and part-time, as well as cash incentives for doctors who want to return to the field.

A new route will open for GPs with previous UK experience – who work in equivalent primary care roles outside the UK – to come back to GP surgeries without needing to sit exams.

A “central contact point” will also be created “for any doctor wishing to return to work in English general practice, so that doctors are supported in navigating any regulatory issues.”

Funding will be made available for GPs suffering from burn-out and stress, and extra cash will be put into indemnity schemes for GPs who face being sued by patients.

The plan also says GP practices rated good or outstanding will only face inspections by the regulator the Care Quality Commission (CQC) every five years to reduce the administrative burden.

Under the plan, money given to NHS England by the Government as core funding will be divided up so general practice receives a larger share than at present.

The amount general practice receives will go from £9.6 billion in 2016/17 to more than £12 billion by 2021 – a 14% real terms increase, NHS England said.

Dr Maureen Baker, chairwoman of the Royal College of GPs, welcomed the move.

She said: “For too long GPs – and our members – have been undervalued, underfunded, and not recognised for the essential role we play in keeping the health service sustainable and safe for patients. We genuinely hope that today’s news marks a turning point for general practice.

“The College has been the leading voice in highlighting the intense resource and workforce pressures that general practice is currently facing, and calling for reform.

“Today’s announcement is a huge and important step in the right direction, and if implemented correctly, our profession, the wider NHS, and most importantly, our patients will reap the benefits.”

Mr Stevens said: “GPs are by far the largest branch of British medicine, and as a recent British Medical Journal headline put it – if general practice fails, the whole NHS fails.

“So if anyone 10 years ago had said: ‘Here’s what the NHS should now do – cut the share of funding for primary care and grow the number of hospital specialists three times faster than GPs’, they’d have been laughed out of court.

“But looking back over a decade, that’s exactly what’s happened.”

He added: “So rather than ignore these real pressures, the NHS has at last begun openly acknowledging them. Now we need to act, and this plan sets out exactly how.”

Dr Chaand Nagpaul, chairman of the British Medical Association’s GP committee, said: “The General Practice Forward View represents a significant and comprehensive package of proposals to support general practice both in the immediate and longer term – the most that we have seen since 2004.

“It is vital that GPs and staff see tangible delivery against these commitments, so that the words are translated into action. GP practices must receive the immediate and urgent support needed, as well as the infrastructure for a sustainable future, which will attract younger doctors to become GPs, and enable existing GPs to remain working.”

Health Secretary Jeremy Hunt added: “This plan represents a significant step forward for General Practice, supporting GPs’ wellbeing and helping us to retain a healthy workforce well into the future.

“It is entirely right that a growing proportion of the extra money the Government announced for the NHS in the Spending Review should go to primary care, so that we can reduce the pressure on GPs and ensure that patients get the most effective and personal care from the people most qualified to help them.”