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Deal to expand GP services to deliver NHS Long Term Plan welcomed by local health and care leaders

Deal to expand GP services to deliver NHS Long Term Plan welcomed by local health and care leaders
04 February 2019

A new five-year contract for general practice across England will see billions of extra investment for improved access to family doctors, expanded services at local practices and longer appointments for patients who need them. 

The deal - the biggest reform to GP services in 15 years – was approved by NHS England last week. NHS England chief executive Simon Stevens said it is the first major pillar implementing the NHS Long Term Plan, coming just three weeks after the Plan was published. 

The new contract has been welcomed by NHS leaders in Cheshire & Merseyside, who said it would accelerate work already underway to sustain and transform primary care.

And they have published a case study showing how four GP practices in Eastern Cheshire are among those already rising to the challenge of working together more effectively.

The extra investment will increase the numbers of clinical staff working in general practice and look to increase the numbers of pharmacists, physiotherapists, paramedics, physician associates and social prescribing support workers in general practice. The contract will also see neighbouring practices working together as primary care networks, with multi-disciplinary teams working alongside other community services. 

Anthony Leo, director of commissioning, NHS England (Cheshire & Merseyside) and senior responsible officer for primary care at Cheshire & Merseyside Health & Care Partnership, said: “This is fantastic news and a welcome boost that will accelerate our programmes of work to support, sustain and transform primary care.  

“One of our key priorities is to grow both the number and the different types of clinicians in the general practice workforce to meet current and future needs of patients, and, in addition to our work to recruit and retain GPs, we have already committed additional local investments to support increases in the wider clinical workforce including nurses, pharmacists, physicians associates and paramedics working in practices across Cheshire and Merseyside.  

“Our work to develop primary care networks is already moving at pace, with 96 per cent of our practices already in networks and we will continue to work closely with our local clinical commissioning groups and practices to support and progress this.” 

The NHS in Cheshire and Merseyside is investing £6m over the next two years to support the development of primary care networks. In total more than 60 local primary care networks have been established with the aim of having primary care networks in place for the entire population by June 2019. 

Other work already underway includes: 

  • NHS England (Cheshire & Merseyside) is putting an additional £180,000 investment, alongside Health Education England funding, to support practices to employ physician associates and embed their roles in general practice. The aim is to have at least an additional 30 physician associates working in general practice by April 2019.
  • Working with training practices in Wirral to pilot rotating trainee physician associates and hospital doctors (foundation year 2 (F2)) so that each gets a mix of primary and secondary care experience.
  • Early in development are plans to implement a rotating paramedic scheme in Sefton and Halton, with the overall aim to enable more paramedics to work in primary care.
  • Plans to substantially increase the number of clinical pharmacists working in general practice.There are 75 clinical pharmacists currently working in general practice across Cheshire and Merseyside. NHS South Sefton CCG and NHS Southport & Formby CCG have 100 per cent clinical pharmacist coverage in their area. 

Case studies - Practices of the future

Middlewood group of practices, Eastern Cheshire

Schoolhouse Surgery in Disley, Eastern Cheshire, is part of the Middlewood group of practices serving just over 32,000 patients.  After seeing a rise in demand for their services, the practices are joining together to become part of the emerging primary care network. The network is looking at how it could change the way it deliver care for its community to ensure it offers a flexible and versatile service to patients.  It works very closely with health and social care colleagues from other NHS organisations and Cheshire East Council

Working collaboratively has allowed the network to employ staff, like pharmacists and physiotherapists, who work across all four practices seeing patients which in turn frees up GP time to see those patients with the most urgent need.  They include a physician associate (PA) – a new healthcare role in general practice in England – who can work alongside GPs and the wider medical team to diagnose and treat patients. PA Alex Facey joined the network in March 2018 and works alongside doctors to support patients.  He performs many different roles across the practices, including regular care home visits, providing proactive care to residents to help reduce hospital admissions, seeing urgent cases in the GP surgery and doing home visits.  All roles help to free up GP time to see other patients. 

Dr Andrew Maurice, GP partner at the Schoolhouse Surgery and member of the Middlewood group of practices, said: “Working together through a primary care network will allow us the freedom and versatility to offer more services for our local population and is encouraging and motivating primary care in our area. 

“Working in a multi-disciplinary team of doctors, nurses, social care workers, pharmacists and physician associates has brought more optimism to our practices and, in the future, will allow us to care for our patients closer to home, offering continuity and personalised care.” 

Click here to watch a video explaining the work of the Middlewood group of practices.

Click here to view a video on the work of physician associate Alex Facey.