Health secretary Jeremy Hunt has restated a commitment to increase the size of the practice nurse workforce, as part of plans to overhaul primary care.
Mr Hunt set out in a speech today what he described as the “first steps in a new deal for general practice”.
The overall aim of the move is to drive through an election pledge to improve access to primary care services at weekends and in the evenings, while also attempting to neutralise arguments from GP leaders about increasing pressures and a lack of doctors.
“I do not pretend to have all the answers today,” he said. “But I want to waste no time in making a start with some important elements.
“Firstly and most urgently we need to deal with concerns about the primary care workforce…So at the election we committed to the challenging objective of increasing the primary and community care workforce by at least 10,000, including an estimated 5,000 more doctors working in general practice, as well as more practice nurses, district nurses, physicians’ associates and pharmacists,” he said.
Mr Hunt noted that these workforce increases would be “informed” by work currently being done on skill mix by Professor Martin Roland for Health Education England. The Primary Care Workforce Commission is scheduled to report this summer.
The health secretary made a particular point of highlighting the expansion of physician associates – formerly known as physician assistants, the role was imported from the US and is often viewed as being a potential career option for nurses.
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“Innovation in the workforce skill mix will be vital too in order to make sure GPs are supported in their work by other practitioners,” said Mr Hunt during a visit to the Nelson Medical Practice in London.
“I have already announced pilots for new physicians’ associates, but today I can announce those pilots are planned to ensure 1,000 physicians’ associates will be available to work in general practice by September 2020,” he added.
“We committed to… 5,000 more doctors working in general practice, as well as more practice nurses, district nurses, physicians’ associates and pharmacists”
He also announced the release of new data on staffing levels across England to enable a greater focus on recruitment to the most “under-doctored” areas.
NHS England will publish data about “clinical staffing levels for every practice in the country”, said Mr Hunt.
“This is not a table of staffing needs, which will vary according to demographic and socio-economic profile,” he said. “But it does indicate that even in areas with similar profiles the variation is unacceptably large.”
In addition, Mr Hunt announced a review of how quality of care in general practice was assessed – potentially sounding the death knell of the quality and outcomes framework, which Mr Hunt called a “tick-box process”.
The health secretary said he had asked the Health Foundation to work with NHS England to do a “stocktake of all current metrics”.
“This stocktake will review where we are now, and how we can collect and publish better outcomes-driven assessments of the quality of care for different patient groups,” he said.
“The Health Foundation will provide an initial assessment for me in the autumn with the first new datasets based around key patient groups published next spring,” he added.
“Innovation in the workforce skill mix will be vital”
He also said he had asked NHS England to look into reducing “bureaucracy, paperwork and inappropriate workload” in primary care in order “to release more clinical time for patients”.
“I have asked to see the results of that work this autumn,” he said.
Citing the new models of care set out last year in the NHS five-year plan – the Five-Year Forward View – Mr Hunt noted he needed the primary care workforce to keep their “side of the bargain” and “help to deliver a profound change the quality of care we offer patients”.
“I am prepared to commit money to this plan – more GPs, more community nurses, more money for infrastructure, help to reduce burnout,” he said.
“The vision for out of hospital care set out in the Five Year Forward View requires more investment in primary care so this is the biggest opportunity for new investment in General Practice in a generation.”
Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “While GPs are central, practice nurses have a huge contribution to make and will be essential if a seven-day service is to be realised.
“There is no one solution to providing a seven-day health service – it will take highly skilled multidisciplinary teams to achieve this goal,” he added.