Presentation from and discussion with Rylla Baker, Deputy Head Primary Care NCEL (London Region) NHS England.
Minutes:
The Deputy Head of Primary Care (London Region) at NHS England explained that strategic planning groups were being introduced consisting of the CCGs from, for example, Barking & Dagenham, Havering and Redbridge. There was increasing to bring CCGs together in order that strategic planning group could take over co-commissioning arrangements for primary care.
NHS England was also required to make a 15% management cost saving which meant 24 people would be lost from the current London team of 108.
The new GP/General Medical Services (GMS) contract from 2015/16 was expected to lead to more GO federations and practices working together etc. There would be more extended GP hours and weekend opening. More effective use of IT would also be expected.
The current (2014) GP/GMS contract had seen money going into practices per patient but would also see the beginning of the removal of the Minimum Practice Income Guarantee over the next seven years. There would also now be a named GP for all patients over the age of 75. This would extend to a named GP for all patients under the 2015/16 contract which would also expect GPs to take over commissioning of an out of hours provider.
The Friends and Family test would start for primary from December with results being published from January 2015. From January 2015, patients would also be able to register with a GP near to where they worked as well as with a home visiting service. New emphasis would be placed on GPs identifying cases of dementia avoiding unplanned admissions to hospital.
It was also explained that patient participation and alcohol reduction services would change under the 2015/16 contract to become contractual requirements of GPs. The formula for calculating pay to GPs would also be reviewed to ensure it was more reflective of levels of deprivation etc. GP net earnings would be published from April 2015.
There were also expected to be a lot of IT changes under the 2015/16 GP contract. All IT funding came from NHS England and GP practices would be expected to introduce on-line services such appointment booking and the availability of medical records.
In Havering for example, the overall number of GP practices had reduced by four over the last year. The number of smaller practices in Havering had also reduced from 21 to 13. The number of whole time equivalent GPs was reducing across the four Outer North East London boroughs and it was accepted that the number of GPs retiring was an issue for the whole area.
The NHS England officer accepted that there was still a difference between list size and the total population for each borough. List maintenance was being undertaken, concentrating on female groups. The overall GP list size for ONEL was however continuing to rise.
GPs were required to provide appointments to meet the reasonable need of their population but it was emphasised that NHS England had no powers or information concerning GP appointments or waiting times. NHS England did wish however to work with CCGs to improve access. NHS England was that patients were able to access a full range of services. The number of sole GP practices in the ONEL boroughs could be provided.
A representative of Havering CCG added that money had been received from the Prime Minister’s Challenge Fund to extend access to GPs. It was hoped that the new GP Federations could be used to provide more appointments and GP services collectively.
Some GP contracts such as those for Personal Medical Services did include key performance indicators and these were monitored by NHS England. The standard GP contract for General Medical Services did not however include these types of indicators.
Complaints about GPs should normally be received by the GP practice itself but these could also be e-mailed to NHS England direct. While NHS England could only collate complaints, this did allow practices which received large numbers of complaints to be identified.
The Committee NOTED the presentation.