NHS England has promised to invest in practice nurse development and return to work schemes, as part of a multi-billion plan designed to “get general practice back on its feet”.
Under the General Practice Forward View, NHS England said would now earmark an extra £2.4bn a year from the NHS budget for general practice services by 2020-21.
“We are determined to get this right for the benefit of patients, GPs and the wider healthcare system”
As a result, primary care spending will rise from £9.6bn in 2016-17 to over £12bn by 2021 – a 14% real terms increase – said the government arm’s length body. It will be supplemented by a £500m national “turnaround” package to support GP practices.
As well as money earmarked for boosting GP numbers by around 5,000 over the next five years, the plan contains “specific, practical and funded steps” to strengthen the wider workforce, drive workload efficiencies, modernise infrastructure and technology, and redesign the way primary care is offered.
NHS England said this will include “nationally funded support” for practice nurses and physician assistants, as well as practice managers and receptionists.
There will be a five-year general practice nurse development strategy, with an extra minimum £15m national investment, according to the plan, which was developed with training and workforce planning body Health Education England.
“It is vital that GPs and staff see tangible delivery against these commitments”
This will cover improving training capacity in general practice, increases in the number of pre-registration nurse placements, measures to improve retention of the existing nursing workforce and support for return to work schemes for practice nurses.
In addition, the plan promises the roll out of the recently published HEE Community (District) and General Practice Nursing Service Education and Career Framework and the accompanying HEE Education and Career Framework.
It also pledges to implement the Queen’s Nursing Institute Voluntary Education and Practice Standards for District and General Practice Nursing, and work with general practice to ensure general practice nurses have access to mentorship training.
The NHS England document stated: “The success of general practice in the future will also rely on the expansion of the wider non-medical workforce – including investment in nurses, pharmacists, practice managers, administrative staff and the introduction of new roles such as physician associates and medical assistants.”
As well as support to “strengthen and redesign” general practice, the plan highlighted the need to deliver extended access in primary care – in line with the government’s seven-day service policy.
It noted it would require “better use of the talents” in the wider workforce, such as advanced nurse practitioners to achieve this.
However, it stated that “delivering improved evening and weekend access is not about every GP or every practice nurse having to work seven days a week”.
“Nor does it mean that every practice in the country needs to be open seven days a week. It will mean that groups of local practices and other providers will be offered the funding and opportunity to collaborate to staff improved in and out of hours services,” added the plan.
NHS England pledges to invest in practice nursing
Dr Arvind Madan, a Tower Hamlets GP and NHS England director of primary care, said: “We are acutely aware of the pressures GPs are facing right now and the need to get on track as quickly as possible.
“This means that practices, working together, will benefit from access to support if they are struggling to meet patient’s needs, reductions in unnecessary workload, more opportunities to recruit staff and a chance to improve use of their technology or premises,” he said.
“We know this is just the start of the journey but we are determined to get this right for the benefit of patients, GPs and the wider healthcare system,” he added.
The plan (see PDF attached below) comes a day after the Queen’s Nursing Institute published a report revealing the pressures facing practice nurses in London and on the same day that MPs also highlighted that primary care was “under unprecedented strain and struggling to keep pace with relentlessly rising demand”.
The “forward view” was welcomed by the Royal College of GPs, the British Medical Association, the Care Quality Commission and the General Medical Council among others.
Dr Chaand Nagpaul, BMA GP committee chair, said: “It is vital that GPs and staff see tangible delivery against these commitments, so that the words are translated into action.”
Headlines from the General Practice Forward View
- An extra £2.4bn a year for general practice services by 2020-21
- Spending will rise from £9.6bn in 2016-17 to over £12bn by 2021
- A £500m national “turnaround” package to support GP practices
- 5,000 extra whole-time equivalent GPs in just the next five years
- 3,000 new fully funded practice-based mental health therapists
- An extra 1,500 co-funded practice clinical pharmacists
- Nationally funded support for practice nurses, physician assistants, practice managers and receptionists
- New practice resilience programme to support struggling practices
- Changes to streamline the Care Quality Commission inspection regime
- Legal limits on administrative burdens at the hospital/GP interface
- Action to cut inappropriate demand on general practice
- New proposals to allow up to 100% reimbursement of premises developments
- Direct practice investment technology to support better online tools and appointment, consultation and workload management systems
- Direct funding for improved in hours and out of hours access, including clinical hubs and reformed urgent care
- A new voluntary GP contract supporting integrated primary and community health services