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GP Forward View

GP Forward View. Transforming Primary Care V0.2. General Practice Forward View: On A Page. Maureen Baker (RCGP President) called this “the most significant announcement for general practice since the 1960s.”. I nvesting a further £2.4 billion by 2020/21 into general practice services .

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GP Forward View

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  1. GP Forward View • Transforming Primary Care • V0.2

  2. General Practice Forward View: On A Page Maureen Baker (RCGP President) called this “the most significant announcement for general practice since the 1960s.” • Investing a further £2.4 billion by 2020/21 into general practice services. • This means that investment will rise from £9.6 billion a year in 2015/16 to over £12 billion a year by 2020/21. • This includes recurrent and transformational funding • Additionally a review on Carr-Hill formula in progress to ensure it reflects derivation and workload etc CHAPTER 1: £ CHAPTER 2: WORKFORCE • Create an extra 5,000 additional doctors working in general practice by 2020 • Attract an extra 500 GPs from abroad and targeted £20,000 bursaries that have found it hardest to recruit. • A minimum of 5,000 other staff working in general practice by 2020/21 • 3,000 mental health therapists • 1,500 pharmacists • £206 million in support for the workforce through: • £112 million (in addition to £31m already committed) for the clinical pharmacist programme to enable a pharmacist per 30,000 population • £15 million national investment for nurse development support including improving training capacity in general practice, increases in the number of pre-registration nurse placements and measures to improve retention of the existing nursing workforce and support for return to work. • £45 million benefitting every practice to support the training of current reception and clerical staff to play a greater role in navigation. • Investment by HEE in the training of 1,000 physician associates to support general practice. Introduction of pilots of new medical assistant roles that help support doctors. • £6 million investment in practice manager development, alongside access for practice managers to the new national development programme. CHAPTER 3: WORKLOAD • Support for GPs to manage demand, unnecessary work, bureaucracy and integration with wider system • £16 million extra investment in specialist mental health services to support GPs with burn out and stress. • new standard contract measures for hospitals to stop work • 3 year ‘Releasing Time for Patients’ programme to reach every practice in the country to free up to 10 percent of GPs’ time (£30m), new four year £40 million practice resilience programme (including £16m in 2016/17) • move to five yearly CQC inspections for good/outstanding practices • introduction of a simplified system across NHS E, CQC and GMC, streamlining of payment for practices,& automation of common tasks. CHAPTER 4: INFRA-STRUCTURE • £900m for premises and IT (this is the continuation of the Primary Care Transformation Fund, now renamed) • £45m for e-consultation support • New rules to allow up to 100% reimbursement of premises developments • Over 18% increase in allocations to CCGs for provision of IT services and technology for general practice CHAPTER 5: CARE REDESIGN • Support to strengthen &redesign general practice by commissioning and funding of services to provide extra primary care capacity across every part of England, backed by over £500 million of funding by 2020/21incl.£171 million one-off investment by CCGs starting in 2017/18, for practice transformational support, introduction of a new voluntary Multi-speciality Community Provider contract from April 2017.

  3. What does this mean for London?

  4. A large proportion of London’s GP practices are working at scale Current picture for London (April 16) NG Key: Population Coverage Enfield NG Harrow Barnet Haringey 50% - 75% coverage Waltham Forest Brent NG Hillingdon NG Redbridge City & Hackney Islington Camden Ealing Non- geographical footprint NG Central London Havering West London Newham Barking and Dagenham Tower Hamlets H&F Hounslow Southwark Lambeth Richmond Wandsworth Lewisham 58 at scale organisations* across London provide coverage for 91%of the population of London 21 CCGsacross London have at scale organisations that provide 100% coverage of their entire population 74%of at scale organisations are geographically aligned 77% of at scale organisations have plans in place to support interoperability across their geographical areas *Currently these are mostly federations Bexley Greenwich Merton Kingston Sutton Croydon Bromley Key: List size of each scale model No data provided <50k 101-200k Less than 50% coverage 50-64k >200k 65-100k List size unknown Greater 75 % coverage Full coverage

  5. Potential Sources of Funding for Primary Care Funding

  6. Including an increase in Primary Care allocations Funding London is expected to receive approximately 15% of the total growth in England’s Primary Medical Services allocations This growth will be split differently across different areas of London based on capitation

  7. Primary Care Allocations & Growth (Forward view) Funding

  8. The GPFV outlines ambitions for more resource and investment National Resource Increase Supporting Activities • Further work to deliver the 10 point action plan • Major national and international recruitment campaigns • Bursaries for the areas which have struggled the most to attract into GP training • Induction and refresher courses for those looking to return to work • Support for flexible working 5,000 GPs 5,000 extra by 2020 3,000 extra MH therapists 5,000 other roles, including Workforce improvement activities 1,500 more clinical pharmacists Additional Funding £143m Clinical Pharmacy Funding • Support for practices to be more resilient • Review of best ways of working to manage outpatient demand • Reduction in CQC inspections for the best rated practices • Programme to release time for patients through • Better automation of tasks where possible Nurse development £15m Workload Improvement activities £45m Reception & clerical staff training £6m Practice Manager Development £100m* Pharmacy integration

  9. Technology & Estates will be well supported to transform Infrastructure

  10. And this will be supported with Regional activity Infrastructure

  11. In London we aim to go beyond the intention of the GPFV (1/2) Below shows the key areas of focus of the General Practice Forward View, whether it is already actively being considered in London through the HLP or other programmes of work. Outlined are also additional complementary activities happening in London CHAPTER 1: INVESTMENT CHAPTER 2: WORKFORCE

  12. In London we aim to go beyond the intention of the GPFV (2/2) Below shows the key areas of focus of the General Practice Forward View, whether it is already actively being considered in London through the HLP or other programmes of work. Outlined are also additional complementary activities happening in London CHAPTER 3: WORKLOAD CHAPTER 4: INFRASTRUCTURE CHAPTER 5: CARE REDESIGN This analysis shows that there continues to be considerable Primary Care development and transformation support across London. Are there other areas which you think are missing?

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