To support the NHS during this period of sustained significant pressure, The NHS has taken action to boost capacity ahead of winter. Recognising the fundamental importance of primary care in underpinning NHS services, a critical part of this plan is to increase capacity outside of acute trusts, which includes the scaling up of additional roles in primary care, increasing the flexibility for primary care networks (PCNs) to do this, and taking further action to support general practice.
To enable this, the NHS are taking several steps over the next few weeks to support the expansion of general practice capacity and reduce both workload and administrative burden. The measures will help general practice focus on access pressures and facilitate system collaboration, working with local providers to manage urgent demand and help address workload challenges.
These actions, mentioned below, will support both practical, rapid improvements for practices, as well as help the NHS move closer to our vision for integrated primary care. Dr Claire Fuller’s Next Steps for Integrating Primary Care outlines our ambition for driving towards integrated neighbourhood teams (INTs) that move beyond PCNs as a fundamental building block of an integrated care system (ICS).
1. An ICB framework for supporting general practice - This framework will support ICS teams to rapidly assess the needs of their practices/PCNs, building on local knowledge, and identify the practical and supportive interventions that would be most appropriate in the short term to boost resilience and patient access. ICBs should prioritise resources where they are most needed.
2. NHS England is committed to supporting the long-term development of neighbourhood multi-disciplinary teams in primary care.
3. Reducing bureaucracy - As part of the public commitment made in Update to the GP Contract Agreement, the Department of Health and Social Care (DHSC) and NHS England have worked to jointly identify areas to reduce workload in primary care. The Academy of Medical Royal Colleges (AoMRC) has been commissioned to identify actionable insights during the next three months where closer clinical collaboration at the interface would have most impact in managing upcoming winter pressures and beyond.
The measures outlined above represent the beginning of a longer journey to support transformation of place-based primary and community care services into integrated neighbourhood teams, while providing a supportive environment to practices and alleviating some capacity pressures to make a tangible difference to patients.
Blood Pressure at Home and remote monitoring
PCNs will be able to make effective use of BP device at Home with remote monitoring to support patients to manage their blood pressure. Technical support services, both IT and EBME will required to make good use of this service.
- Realistic improvements should be delivered as a result of BP at Home and remote monitoring.
Additional capital funding for primary care
The NHS is interested in urgently scoping where any additional capital investment in primary care would make a difference to front-line service delivery and support resilience over winter and beyond.
They have listed below some initial ideas around investment on areas/tools that would deliver change most quickly and easily, with a view to improving the experience of both patients and staff. Work to date and feedback from ICS and practice teams suggests that the following types of investment may be most valuable in the short term:
- Digital interoperability and other tools to support cross PCN working, including delivery of enhanced access services at PCN level.
- Rapid improvements in primary care estates, especially to support optimal use of ARRS roles eg creation of additional consulting rooms.
- Increasing use of automation of business/back office functions in general practice
