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Hunt promises ‘new deal’ for GPs in return for seven-day services

The health secretary has promised a “new deal” for general practice, including funding and investment in the workforce, in return for seven-day opening.

The deal includes at least 10,000 extra primary care staff, including 5,000 more GPs and a trial of 1,000 new physician associates.

Jeremy Hunt said: “Innovation in the workforce skill mix will be vital to ensure GPs are supported in their work by other practitioners.

“I have already announced pilots for new physicians associates, but today I can announce that those pilots aim to ensure 1,000 physician associates will be available to work in general practice by September 2020.”

The additional primary care staff will also include pharmacists, with another £7.5m to go towards supporting community pharmacists.

Announcing the deal in a speech in south London today, the health secretary said that investment in general practice will come from the £1bn primary care infrastructure fund announced last year. More than 1,000 GP practices have now had bids approved provisionally for £190m in investment in premises.

 “If we do not find better, smarter ways to help our growing elderly population remain healthy and independent our hospitals will be overwhelmed – which is why we need effective, strong and expanding general practice more than ever before in the history of the NHS,” Hunt said.

“I am keeping my pledge to announce a new deal for general practice. If we are to have a new deal I will need your co-operation and support – both in improving the quality and continuity of care for vulnerable patients and delivering better access, seven days a week, for everyone.

“Work together on a new deal and we really can transform the quality of primary and community services for patients, reduce burnout and put the inspiration and magic back into general practice. I hope you will join me on that journey.”

However he also stressed that the promised investment would in return for a move to seven-day services.

The health secretary also announced a range of measures to tackle workforce issues that had previously been put forward by NHS England, Health Education England, the BMA and the RCGP as part of their 10-point workforce plan.

They include:

• A marketing campaign led by NHS England and the RCGP to attract medical graduates to the profession;
• A returners scheme, which has already attracted 50 GPs back to English general practice;
• A scheme to retain GPs nearing retirement age, which is being worked on with the BMA;
• New data from NHS England on staffing levels to help focus recruitment on under-doctored areas;
• Extra year of education for trainee GPs in a clinical speciality relevant to primary care, such as paediatrics, psychiatry or emergency medicine.

The additional resources being made available to general practice have been widely welcomed, however many still remain sceptical of the seven-day service.

Dr Nav Chana, chairman of The National Association of Primary Care (NAPC), said: "This approach to workforce development in primary care must be focused on building teams with the right skills needed to address local population needs as well as addressing shortages in GP numbers.

"NAPC recognises the importance of improving access to primary care across seven days, however, we need to ensure we first get the system right ‘in hours’ and build on the evidence around patient access to avoid falling in the trap of supply-induced demand. In addition there may be many more solutions to be explored for providing a seven-day service.”

Dr Chaand Nagpaul, chair of the GPC, said that the priority should first be to address the overwhelming workload pressures currently faced by GPs as recruitment and retention would not improve until general practice is re-established as “a career that is rewarding and appealing”.

“It is vital that government  moves beyond rhetoric and brings forward tangible resources and practical solutions to stabilise general practice, and give GP s the time and tools to care holistically for patients  We need urgent action now, not just aspiration for the future,” he said.

Rob Webster, chief executive of the NHS Confederation, welcomed the recognition that primary care extends beyond GPs. He advocated a “whole-system approach” to service and workforce planning “built on communities”.

RCGP chair Dr Maureen Baker said: “The secretary of state makes many commitments which, if they come to fruition, will put general practice on a more stable and secure footing for the future and ensure that family doctors can keep pace with rocketing patient demand and increasingly complex caseloads.

“What we need now is a clear and costed plan for turning this into a reality – and a timescale for how quickly this can be delivered.

"As Mr Hunt describes, many practices are already providing extended opening hours in the evening and at weekends and access to GPs for urgent care is available through GP out of hours services 24/7.

"But without this additional funding and sufficient numbers of GPs, it is simply not possible for us to deliver a seven day service for routine care in every general practice, especially when there are currently huge swathes of the country where the GP shortages are so severe that they are struggling to provide even a five day service.”

Co-chair of NHS Clinical Commissioners, Dr Steve Kell, said: “Vital to the development of this work will be to ensure that CCGs have the tools, capacity and resource to support practices effectively, which must include funding choices and running cost flexibility. It is essential CCGs are enabled to shift funding and support into out of hospital services as described in the Five Year Forward View, and deliver genuine support for practices.”

(Picture by: Neil Hall / PA Wire)

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