The document discusses plans to improve access to general practice services in England by October 1st, 2018. It outlines that patient satisfaction with making appointments has declined in recent years. The GP Forward View aims to strengthen general practice through extended access to services. All clinical commissioning groups must provide extended access to GP services in the evenings and weekends for 100% of the population by October 2018. The document details the seven core requirements for extended access and over £348 million in funding that has been made available to CCGs to implement the changes.

1. www.england.nhs.uk
GPFV General Practice Transformation Champions Event
22 March 2018
Improving access to general practice:
accelerating delivery to 1 October
2018

2. www.england.nhs.uk
Why do we need to improve access?
GP Patient Survey
• Good overall experience of making an appointment declined from
79.1% in 2011/12 to 72.7% in 2016/17
• 11% (1 in 10) reported not being able to get appointment
• Likelihood of getting convenient appointment lower if you are in
work or young
GP Forward View
• Represents a turning point in investment
• Sets out support package
• Sets out the ambition to strengthen and redesign general
practice, including delivering extended access in primary
care
• Vision builds on the potential for transformation in general
practice and GP Access Fund:
• Enabling self care and direct access to other services
• Better use of the talents of the wider workforce
• Greater use of digital technology
• Working at scale across practices to shape capacity

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What are we trying to do?
Refreshing NHS Plans for 2018-19 (published February
2018) requires provision of extended access to GP
services, including at evenings and weekends, for 100%
of the population by 1 October 2018.
“Ensure everyone has easier and more convenient access to GP
services, including appointments at evening and weekends”

4. www.england.nhs.uk 4
Timing of
appointments
• Commission weekday provision of access to pre-bookable and same day appointments to general practice services
in evenings (after 6.30pm) – to provide an additional 1.5 hours every evening
• Commission weekend provision of access to pre-bookable and same day appointments on both Saturdays and
Sundays to meet local population needs
• Provide robust evidence, based on utilisation rates, for the proposed disposition of services throughout the week.
Capacity
• Commission a minimum additional 30 minutes consultation capacity per 1,000 population per week, rising to
45 minutes per 1000 population
Measurement
• Ensure usage of a nationally commissioned new tool to be introduced during 2017/18 to automatically measure
appointment activity by all participating practices, both in-hours and in extended hours. This will enable
improvements in matching capacity to times of great demand.
Advertising and
ease of access
• Ensure services are advertised to patients, including notification on practice websites, notices in local urgent
care services and publicity into the community , so that it is clear to patients how they can access these
appointments and associated service;
• Ensure ease of access for patients including:
• All practice receptionists able to direct patients to the service and offer appointments to extended hours
service on the same basis as appointments to non-extended hours services
• Patients should be offered a choice of evening or weekend appointments on an equal footing to core hours
appointments.
Digital • Use of digital approaches to support new models of care in general practice
Inequalities
• Issues of inequalities in patients’ experience of accessing general practice identified by local evidence and actions
to resolve in place
Effective access to
wider whole
system services
• Effective connection to other system services enabling patients to receive the right care the right professional
including access from and to other primary care and general practice services such as urgent care.
What have we got to deliver: seven core requirements

5. www.england.nhs.uk 5
What finances are being made available to CCGs?
£138m £258m £348m
Commissioners:
 will receive £3.34 per head for
those not yet commenced in 18-
19
 NHS England has confirmed the
value of allocations for 18-19
based on weighted population,
(minimum provision also based
on weighted population)
 Need to commission services that
meet national core
requirements.
 Spend £3 per head (non-
recurrent) on practice
transformational support
(commencing 17-18 and can take
place over two years, £3 in 17-18
or 18-19 or split over the two
years)
 Must follow correct procurement
processes.

6. www.england.nhs.uk
Procurement
6
Develop specification, market and patient
engagement
Issue
PIN Undertake procurement
March
2018
Oct
2018
Mar
2019
Develop local provider / follow SFIs to secure interim service
Service
begins Interim service in place
 CCGs will need to secure services through appropriate procurement processes which means they
must adhere to the public contract regulations 2015. These set out that contracts for clinical
services that are above the threshold (£615,278) may need to be advertised in the Official Journal of
the European Union (OJEU) dependent on whether one of the exemptions applies.
 CCGs should use APMS to contract extended access services. Exit and entry into a primary care
contract can only be issued by NHS England, therefore the local office (DCO) will need to sign the
contract on behalf of the CCG.
 Where CCGs have not yet commenced preparatory work or developed a service specification, they
may need to consider an interim solution, as in the example set out below:

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Four key elements :
• Direct peer to peer support from a named ‘buddy’ to
access support as and when required : 25 buddies are
currently part of the network.
• Buddying directory shared with CCGs providing
details of all buddies and their areas of expertise.
• Regional marketplace events bringing together local
CCGs and relevant buddies to provide information and
examples of how they have identified and tackled
challenges and opportunities within their own schemes.
Further events taking place in Cambridge on 27 March,
London on 24 April and Manchester on 8 May.
• Online networking forum sign up at
www.networks.nhs.uk/nhs-networks/improving-
access-to-general-practice-commissioner to connect
with the national team, buddies and other
commissioners.
Support to share best practice and learning
The buddying network is helping to ensure that CCGs who are developing improved access can benefit
directly from the knowledge and experience gained through the GP Access Fund. CCGs can access the
buddying network through their regional NHS England team or by contacting england.gpaccess@nhs.net.

8. www.england.nhs.uk 8
Regional and local office (DCO) teams will support CCGs
directly, with additional national support to deliver access
and core requirements. An assurance process is in place to
support delivery.
What is already available?
 Communications Guide and Resource Pack supports
commissioners and providers to meet the core
requirement to ensure services are advertised to
patients. Accompanied by a range of advertising
resources, including posters, web banners etc.
 Inequalities Resource designed to support the core
requirement to address issues of inequalities in patients’
experience of accessing general practice and put actions
to resolve in place.
 Case studies and innovation showcases: sharing learning
from the GP Access Fund pilot schemes and other areas.
 Subject specific webinars and workshops on
procurement, inequalities and communications with
other topics which can be tailored to local needs.
What will be published soon?
 A package of support products to support regions and
CCGs to deliver improved access in line with the
refreshed Planning Guidance . This will include updates
of the inequalities resource and communications guide,
plus Top Tips for General Practice Providers, a National
Equality Impact Assessment , procurement guidance,
further information about the core requirements and
FAQs.
All resources are available at www.england.nhs.uk/gpaccess
What additional support is being offered
nationally?

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Webinars to support delivery
NHS England will be hosting a series of webinars to help CCGs and commissioners deliver the requirements as
set out in the Planning Guidance 2017-19. The dates for these webinars will be circulated shortly and can be
accessed via our website: www.england.nhs.uk/gpaccess
Accelerating Delivery: Improving Patient Satisfaction
• 1 May, 10-11am
• 16 May, 10-11am
Accelerating Delivery: The Practice Experience
• 3 May, 12.30-1.30pm
• 15 May, 12-1pm
Accelerating Delivery: The Impact on Non-Elective Admissions
• 10 May, 11-12pm
• 15 May, 9-10am
Accelerating Delivery: Utilisation Rates
• 2 May, 2-3pm
• 7 May 1-2pm
Communications and Engagement
• 25 April, 1-2pm
• 1 May, 3-4pm
Further webinars on addressing inequalities in access will follow.

10. www.england.nhs.uk
Summary of next steps
Commissioners will want to ensure:
 They are clear about procurement timelines and how to achieve them.
 There is a plan in place, if needed, to deliver an interim procurement solution to
ensure delivery by 1 October 2018 (in line with local SFIs).
 The planned service delivery is supported by compatible IT systems. If
interoperability is an issue, that they know how to overcome this e.g. purchasing a
system solution such as Black Pear?
 There is a communications and engagement plan in place and discussions with
stakeholders are commencing, to develop the requirements for a specification.
 They have considered the most effective way of utilising available funding to drive
transformation.
 Once the service is in place, that all local providers are aware of the best way to
access the service e.g. ensuring the local Directory of Services (DoS) is updated.

11. www.england.nhs.uk
Key messages to take away
 This is not simply about delivering more of the same, its about making the
most of our opportunity for transformation as part of the General Practice
Forward View. This includes better integration between services such as NHS
111 and urgent care services such as GP Out of Hours.
 Additional access funding is intended to develop general practice at scale as
part of a wider set of integrated services, not just deliver additional
appointments.
 The most important part of implementation is for us to take the opportunity
to invest in general practice to enable sustainability today and
transformation tomorrow and make the service better for patients and health
practitioners (clinicians and staff) alike.

12. Mike Windibank
IT and Data Manager
Southampton Primary Care Limited

13. Southampton Primary
Care Limited

14. Aldermoor
Health Centre
Shirley Health
Partnership
Portswood
Surgery
St Mary’s Surgery
Woolston Lodge
Surgery
Number of patients covered: 269,875
Number of practices participating: 26
Clinical Commissioning Group covered: 1
Chessel Surgery

15. Patients

16. Objectives
• Increase access to primary care services
• Integrating health and social care with provision specific to need
• Full access to medical records
• Improve quality of care and patient experience
• Increase efficiencies and sustainability of primary care services
• Reduce duplication and centralise coordination
• Provide robust governance, quality assurance and audit reporting
• Use economies of scale to improve system resilience
• Make Southampton a better place to be a patient

17. Benefits for patients
• Increased access (time and place)
• Community based (familiar setting, more reassuring)
• GP led : experience of local services
• Wider range of services offered
• Integrated working : single story and coordination of
care to include specialist services
• Increased patient safety

18. Supporting patients
• Workers
• Patients with low level mental health problems
• Young people with sports injuries
• Patients needing dressings
• Support for Nursing and Care Homes
• Patients calling 111

19. Supporting patients
• Support for the Ambulance service
• Long Term Condition management
• Additional Primary Care Service in Emergency
Department
• Contraception services
• Home Visiting for practices
• MDT Care Home Service

20. Benefits for practices
• Workforce: more efficient use resources (skills
and sites)
• MDT holistic approach (upskilling and
diversifying)
• Working at scale: access to local specialist skills
• Strength of collective GP experience to drive and
effect change – service redesign
• Wider range of services offered
• Reduction in workload

21. Supporting practices
• Training college
• Cluster and MDT support
• Centralised bidding
• Single voice for Primary Care in system level
dialogue
• Clinical and Administrative support to practices
struggling with recruitment and staff sickness

22. Patient Feedback
• FFT Average for Extremely Likely / Likely is over 97%
• “This is a brilliant service - worked really well for me, when I had to have
my leg packed daily. Recently I felt unwell I couldn't get an apt at my
surgery - but was a able to see a nurse practitioner at a Hub later on the
same day - and they can access your records. Excellent service :-)”
• “Useful opening times especially as I get home late from work and cant
see my doctor in regular hours some days”
• “I couldn’t get an appointment with my GP so was offered an
appointment at your Hub. I’d never heard of it until then - I was really
impressed, the whole experience was great. The doctor didn’t rush, the
receptionist was chilled and chatty. And if it helps relieve the pressure
on A&E then it’s a double whammy!”
• “This hub is a fantastic and accessible idea to meet
the needs of working people”
• “Very welcoming and friendly staff
- very good service would def recommend”
• “Really helpful to be open weekends”

23. Practice Feedback
• “A.V.S. and extra hub apps very helpful to us.
THANK YOU. Martin. H.”
• “I just wanted to say thank you for your efforts
yesterday sorting out the Physio appointment at
the Adelaide for our patient. It was very kind of
you to ‘go that extra mile’ and also to phone the
patient and explain the situation to her. What a
great service!”

24. Thank You
Mike Windibank
IT and Data Manager
Southampton Primary Care Limited
mike.windibank@nhs.net

25. www.england.nhs.uk
Email: england.gpaccess@nhs.net
www.england.nhs.uk/gpaccess
Questions?