ChallengeNHS England has provided an additional 258m on top of existing primary medical care allocations to enable CCGs to commission and fund extra capacity to ensure that everyone has access to GP services, including sufficient routine and same day appointments at evenings and weekends to meet locally determined demand, alongside effective access to other primary care and general practice services such as urgent care services.
The NHS originally set out the target to ensure that by March 2018 50% of the population had access to extended GP services
with 100% achievement by March 2019. In February 2018 NHSE brought forward the March 2019 target to October 1st 2018.
Each of the 4 regions had been receiving funding at different rates. Midlands and East was funded to ensure that by March 2017 20% of the population benefit from extended access, rising to 29% by March 2018, with 100% by March 2019.
Midlands and East now has to increase coverage by an additional 71% in a timeframe of 8 months Funding to create new schemes however will not be available until June 2018.
In order to be eligible for additional recurrent funding, CCGs need to commission the service and demonstrate the following seven quality standards (Core Criteria):
Weekday provision of pre-bookable and same day appointments to general practice services in evenings (after 6:30pm) and at weekends.
Minimum additional 30 minutes consultation capacity per 1000 population.
Measurement of appointment activity by all participating practices, both in-hours and in extended hours.
Services are advertised to patients, including notification on practice websites, notices in local urgent care services and
publicity into the community.
Digital approaches are used to support new models of care in general practice.
Inequalities issues are addressed in patients’ experience of accessing general practice.
Connections are made to other services such as urgent care.
To ensure that targets are met and that CCGs are supported in achieving this target the GPFV team set out a 2 year work programme which is summarised as follows:
- Ensuring a solid baseline to assess current and future performance including data cleansing (ensuring DES activity removed and full 7 day services for all live schemes)
- Seven Core Criteria Audit Programme. All live CCGs are undertaking a detailed audit of access delivery with regional assistance.
- Advertising audit – all live CCGs have performed regular audits of practices that are advertising services.
- Support to non-live CCGs with scheme planning/delivery. A delivery plan template has been produced to assist CCGs in planning schemes with a regional monitoring process.
- Identification of CCG/Provider knowledge gaps with training events.
- Joint working with Urgent and Emergency Care
The above is supported by a DCO/PMO assurance/reporting structure feeding up to the national team, engaging widely with national, regional and local colleagues, as well as with legal advisors.
The NECS team have been instrumental to driving forward delivery within the Region, providing capable and engaging programme support to local STP teams whilst also strengthening Regional coordination. The NECS team is characterised by flexibility and positivity – key requirements of effective programme delivery
The December 17 GPFV Monitoring Survey data has confirmed that for Midlands and East current population extended access coverage is 32.9% with a projected coverage of 33.2% by March 2018, indicating that Midlands and East are currently exceeding target coverage.
It is highly likely that the March 18 levels will exceed 33.2% as several substantial schemes have achieved 100% population coverage during late November early December 2017 as well as a number of CCGs who have commenced delivery in advance of national funding being available to them.
An accelerated programme has been implemented to achieve the new October 1st 2018 target for 100% population coverage and the team are working closely with NHSE staff and CCGs to identify and find solutions to the challenges faced.