Primary care recovery plan: Health and Social Care Secretary statement
Health and Social Care Secretary oral statement to Parliament on the primary care recovery plan, delivered in the House of Commons.
Madame Deputy Speaker, with permission I would like to make a statement on the primary care recovery plan.
For most of us, general practice is our front door to the NHS.
In the last 6 months, over half the UK population has used GP services and GPs in England carry out around one million appointments, every single day.
They’re doing more than ever.
General practice is delivering 10% more appointments a month than before the pandemic - the equivalent of the average GP surgery seeing about 20 additional patients, every working day.
There are more staff than ever, with numbers up by a quarter since 2019 and we are on track to deliver our manifesto target with an additional 25,000 staff already recruited into primary care.
And we are investing more than ever too, with the most recent figures [2021] showing that funding was around a fifth higher than 5 years before, even once inflation is taken into account.
But we know there is a great deal still to do.
And COVID-19 presented many challenges across the health service leaving us with large numbers of people on NHS waiting lists, which need to be tackled.
In general practice, patient contacts with GPs have increased between 20% and 40% since before the pandemic.
As well as recovering from the pandemic, we face longer-term challenges too.
Since 2010, the number of people in England aged 70 and above has increased by a third and this group attends 5 times more GP appointments than young people.
Not only that, advances in technology and treatments mean that people understandably expect more from primary care systems.
So Madame Deputy Speaker, today I can announce our primary care recovery plan and I pay tribute to my honourable friend the member for Halborough for his work on this plan.
And I have deposited copies of the plan in the libraries of both Houses.
Our plan will enable us to better recover from the pandemic to cut NHS waiting lists and to make the most of the opportunities ahead, by focusing on 3 key areas:
First: tackling the 8am rush, by giving GPs new digital tools.
Second: freeing up GP appointments by funding pharmacists to do more - with a ‘Pharmacy first’ approach.
And third: providing more GP staff and more appointments.
NHS England and my department have committed to make over £1.2 billion of funding available to support the plan in addition to the significant real-terms increases in spending on general practice in recent years.
And taken together, our plan will make it easier for people to get the help that they need.
Madame Deputy Speaker, the plan builds on lots of other important work.
Last year, we launched the elective recovery plan, which is making big strides to reduce the backlog brought about by COVID-19.
And we eliminated nearly all waits of over 2 years by last July and now 18-month waits have decreased by over 90% since their peak in September 2021.
And by contrast Madame Deputy Speaker, in the NHS in Labour-led Wales people are twice as likely to be waiting for treatment than in England.
They still have over 41,000 people waiting over 2 years and nearly 80,000 waiting over 18 months. [81,727 as of Feb 2023 (latest).]
In addition, this January I came before the House to launch our urgent and emergency care plan focused on how to better manage pressures in emergency departments with funding to support discharge to improve patient flow within hospitals.
And so today’s plan is the next important piece of work.
Tackling the 8am rush
Madame Deputy Speaker, turning to the detail of the plan.
Our first aim is to tackle the 8am rush.
And we will do this by providing GPs with new and better technology moving us from analogue ways of working to the digital age.
An average-sized GP practice will get around 100 calls in the first hour of a Monday morning.
But no team of receptionists - no matter how hard-working - can handle such demand.
About half of GPs are still on old analogue phones meaning that, when things get busy, people get engaged tones.
So we’re changing this, by investing in modern phone systems for all GPs including features such as call-back options and by improving the digital front door for even more patients.
In those GPs that have already adopted these systems there has been a 30% improvement in patient feedback on their ability to access the appointments that they need.
And this also reflects the fact that online requests can help find the right person within the practice such as being directed to a pharmacist for medicine prescription review or to a physio for back pain.
In doing so, we will make the most of the 25,000 more staff we now have in primary care.
Today’s plans fund practices without this technology to adopt it while also providing them with staff cover to help them manage a smooth transition onto this technology.
Many small GP practices in particular find it hardest to fund new technology or manage the disruption that comes with transitioning to new ways of working.
So, we are funding locum cover alongside the tech itself.
Notwithstanding Madame Deputy Speaker, people will always be able to walk in or ring in if they’d prefer and if someone wants to ring up and see someone face to face, these investments make that easier.
We’ll also want to make sure patients know how their request is going to be handled on the same day that they make contact.
Clinically urgent issues will be assessed on the same day - or the next day if raised in the afternoon.
And if not urgent, an appointment will be scheduled within 2 weeks.
But crucially Madame Deputy Speaker: people won’t be asked to call back tomorrow.
Instead, they’ll get their appointment booked in that same day, or be signposted to other services.
Pharmacy First
Turning to the second area of this plan and Pharmacy First.
As well as giving GPs new technology, I know we need to take off pressure off GPs where possible by making better use of the skills of all clinicians working in primary care.
We saw the incredible role pharmacists played during the pandemic - their capacity to innovate and deliver for the communities that they served and to free up GP appointments in doing so.
So, the second part of our plan is to introduce a new NHS service - Pharmacy First - on which we are already consulting with the pharmaceutical services negotiating committee.
80% of people live within a 20-minute walk of a pharmacy so making it easier for pharmacists to take referrals can have a huge impact.
Referrals might be from GPs, NHS 111 or from next week [15 May 2023], from urgent and emergency care settings.
Community pharmacies already take referrals for a range of minor conditions such as diarrhoea, vomiting and conjunctivitis.
But with our Pharmacy First approach, we can go further still.
We will invest up to £645 million over the next 2 years so pharmacists can supply prescription-only medicines for common conditions like ear pain, UTIs and sore throats without requiring a prescription from a GP.
One of the most significant shifts we’re making is on oral contraception.
Pharmacists can already manage the supply of contraception prescribed elsewhere.
And from later this year they will also be able to start women on courses of oral contraception.
This is another way in which we aim to reduce the barriers to women accessing contraception in light of our Women’s Health Strategy.
Pharmacists will also be able to do more blood pressure checks, which is one of the most important risk factors for cardiovascular disease.
Not only will these kinds of steps make it easier for people to get the care they need we expect it to release up to 10 million appointments a year by 2024 to 2025.
More staff, more appointments
Madame Deputy Speaker, the third part of our plan is about providing more staff and more appointments.
We’re making huge investments in our primary care workforce and are on track to meet our manifesto commitment of having 26,000 more primary care staff by next March meaning we have more pharmacists, physios and paramedics delivering appointments in primary care than ever before.
In 2021, we hit our target of 4,000 people accepting GP training places and our upcoming NHS workforce plan will set out how we’ll further expand GP training.
We’re also helping retain senior GPs by reforming pension rules and lifting 9,000 GPs out of annual tax charges.
These are the pension reforms that the BMA welcomed describing them as “significant and decisive changes” and citing them as “transformative for the NHS”.
As well as freeing up more staff time, our plan cuts bureaucracy too so GPs spend less time on paperwork and more time caring for patients by removing unnecessary targets improving communication between GPs and hospitals and reducing the amount of non-GP work GPs are being asked to do.
For example, patients are often discharged from hospital without fit notes meaning they then have to go to their GP to get one.
By the end of this year, NHS secondary care services - who will understand those patients’ conditions better - will be able to issue fit notes.
And we’ve streamlined the number of targets on primary care networks from 36 down to just 5.
Taken together, this work will free up around £37,000 per practice.
So Madame Deputy Speaker today’s primary care recovery plan funds and empowers our GPs and pharmacists to do more so we can prevent ill health keep cutting NHS waiting lists and improve that vital front door to the NHS for many millions of people.
I commend this statement to the House.