The health secretary has placed GPs at ‘the heart’ of new prevention-focused reforms, despite acknowledging the perception that primary care is ‘far too stretched’.
Announcing his long-term vision for NHS reform today (8 March), Sajid Javid presented a series of sweeping intentions to improve the system, with a greater focus on prevention.
He suggested that prevention has been ‘consistently under-prioritised and underutilised’ within the NHS, adding that the Government must place GPs and other primary care staff ‘at the heart of this new agenda’.
Mr Javid said he was aware there is ‘a sense that primary care is far too stretched to be proactive on prevention’ and added that there is a need for ‘reform that works for populations and the profession alike’.
However, he did not clarify what these reforms may entail, or how they will support GPs.
He did note that Claire Fuller, Senior Responsible Officer for the Surrey Heartlands ICS, is currently conducting a review into how Integrated Care Systems (ICSs) can support primary care networks (PCNs).
Patients to be offered choice at point of GP referral
Under the new plans, patients will also be informed of average waiting times at the point of referral, with those patients facing the longest waits getting the option to change provider.
According to the DHSC, all patients that have been waiting for 18 months or more will be contacted to discuss the choices they have about changing provider by the end of this year.
Reforms up for consideration include:
- Expanding the target of granting 200,000 people personal health budgets by 2024
- Increasing use of the NHS App to help people manage their health
- Ensuring 90% of trusts are using electronic records by December 2023.
It also confirmed that the Government and NHS will ‘review and improve’ the quality of data on waiting times to help GPs offer more choice, including in the private sector.
Responding to the measure – which is currently under consideration as part of the long-term vision – Nigel Edwards, Nuffield Trust’s chief executive, said that ‘above all’ the plans must help general practice ‘survive the immense pressure it faces’.
General practice is ‘the bedrock of the NHS and the part we rely on to coordinate care around patients’, but he warned ‘it is in danger of failing’.
He said: ‘The Secretary of State will need to carefully incentivise general practice to work in bigger units and develop more administrative ability, making use of digital technology for patients able to use it and offering alternatives for those that can’t.’
Patient choice is ‘no replacement’ for lacking staff
Hugh Alderwick, head of policy at the Health Foundation, said that the ‘biggest challenge facing the NHS right now is chronic staffing shortages’, adding that a fully funded workforce strategy is ‘essential’.
He warned that the measures towards greater patient choice were ‘no replacement’ for having enough staff to and capacity to deliver the services.
Similarly, Dr Chaand Nagpaul, BMA council chair, said that without a ‘proper and transparent workforce strategy’ long-term vision will ‘ultimately fail’.
Patients can only be offered these choices if there are enough staff to deliver them, and currently there is ‘no clear plan’ to achieve this, he said.
He said: ‘Immediate steps must be put in place taken to retain current staff, and this must include measures to reform punitive pension rules that are currently driving senior clinicians to reduce their hours or leave the NHS altogether, which is dramatically slowing down progress on tackling the backlog.’
It comes after the House of Lords yesterday voted to ensure the Government published regular health and care workforce projections, reversing the Commons’ rejection last year.
Last week, NHS Digital data revealed that the overall number of staff vacancies in England had topped 110,000 as of December 2021, increasing by more than 20,000 across the year.