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Primary care

What are our overall aims by 2028?

Everyone who needs an appointment with their GP practice gets one within the appropriate period of time depending on urgency, and patients are offered an assessment of need, or signposted to an appropriate service, at first contact with their GP practice.

Our local general practice workforce continues to increase in numbers and broaden in terms of roles and skills, including through all PCNs maximising opportunities to employ or have access to additional roles through the national Additional Roles Reimbursement Scheme.

Infrastructure development supports and enables improved access, through improved IT and telephony systems, and estates. Funding opportunities are maximised in support of this.

Our GP practices and PCNs play an integral part in the design of Integrated Neighbourhood Teams and the delivery of fully integrated, Place-based out of hospital care through these Teams.

Patient experience of access to general practice improves as reflected in the results of the national GP Patient Survey.


What’s our starting point?

NHS England has published the national Delivery Plan for Recovering Access to Primary Care.  The national plan will be critical in shaping our local plan to support practices and PCNs to improve access.  Our system wide Primary Care Collaborative will co-design the local plan, with delivery being driven through the ICB’s Primary Care Group.

The ICB is using national appointment data to monitor the local access position at all levels of the system. Engagement is undertaken with individual practices to verify the data, understand key challenges and issues impacting the practice and develop targeted support offers.

On 1 April 2023, the ICB will take responsibility for commissioning pharmacy, optometry and dental services.  This presents an opportunity for the ICB to implement approaches to improve access through increased integration across the pharmacy and general practice sectors, as well as to focus on the recovery of access to dental services.


What are some of the key links to other parts of the plan?

System Transformation – joining up care and services at a local level will be critical to our success in improving access across the next five years.  Our two geographic Care Collaboratives, our Primary Care Collaborative and our Mental Health Collaborative will play leading roles in doing this.

Improving Access to Services - Urgent and Emergency Care – collaborative work is planned in each of our Places to develop integrated urgent care pathways in the community.

Collaboration and Integration – our local PCNs are extending access to general practice services across weekday evenings and weekends through ‘Enhanced Access’ service offers. PCNs are also delivering targeted interventions to improve access for specific groups, including those experiencing inequalities.

Population Health Management – PCNs are using Population Health Management to increase their understanding of their patient populations and to enable them to take action to improve access in a planned way.


What will we be focusing on in the next 2 years?

Defining our local support offer to practices and PCNs in response to the national Delivery Plan for Recovering Access to Primary Care, in co-production with our Primary Care Collaborative and with a specific focus on:
- Addressing variation and inequalities; and 
- The four prioritised areas in the national plan: empowering patients; implementing modern general practice access; building capacity; and cutting bureaucracy.

Increasing our ability to accurately understand demand and capacity in general practice to inform planning and action, initially engaging with all local GP practices to verify national appointment data in light of known data quality issues.

Improving information about quality and access to services both to strengthen accountability to the public and to support clinical teams in continuous quality improvement.  Specifically we will develop a quality and productivity dashboard to enable targeted and funded formative support to practices and PCNs.

Developing resilient infrastructure around our GP practices through the delivery of projects within our General Practice Estate and General Practice Information and Communication Technology Programme Plans, refreshing both Plans during 2023/24.

Delivering local trajectories relating to the recruitment of staff to work in additional roles in general practice, including by maintaining a dedicated local support offer via the Coventry and Warwickshire Training Hub.

Delivering a broader support offer to local GP practices through the Training Hub, focusing on recruitment and retention.

Supporting our local PCNs through dedicated management support and a dedicated leadership forum.

Working with our PCNs and constituent GP practices to develop and agree PCN and Practice Access Improvement Plans for 2023/24.

Engaging with local GP Federations and our Primary Care Collaborative to explore opportunities for the Federations to support improved access.

Working with other ICBs across the West Midlands to develop and embed the operational model for delegated commissioning of pharmacy, optometry and dental services.

Developing direct and self-referral pathways across a number of service areas removing the need for GP involvement/appointments.

Increasing the number of local pharmacies delivering the Community Pharmacist Consultation Service and the number of referrals into this service from local GP practices. 


Key Challenges

The 2023/24 national contract for general practice has not been agreed by the national representative body. The local implications of this are unclear at the current time; however, there may be impacts to the delivery of our identified aims.

2023/24 is the final year of Investment and Evolution the national five-year contract agreement for general practice.  The contract agreement for 2024/25 and beyond will be developed through engagement and negotiations at a national level. The national contract will be key in shaping local planning for later years covered by this plan. In the absence of an agreed national position, the vision and direction of travel set out in the Fuller Stocktake will inform local planning. 

As reflected in the Fuller Stocktake Report, change and action is required at a national level across a number of areas to deliver improved access.


Key Metrics and Deliverables

Metrics/deliverables derived from the national Delivery Plan for Recovering Access to Primary Care, published on 9 May 2023.

Delivery of Additional Roles Reimbursement Scheme (ARRS) recruitment trajectories.

CPCS – increased number of pharmacies delivering/increased number of referrals generated by GP practices.

Recover dental activity improving Units of Dental Activity towards pre-pandemic levels.