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Long term plan: the sector reacts

by Valeria Fiore
9 January 2019

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NHS England has published its long awaited long term plan earlier this week, confirming its anticipated commitment to prioritise primary and community care.
As part of measures to better care for patients at community level, primary care and local services will receive £4.5bn a year in real terms by 2023/24 through a ring-fenced investment that NHS England said ‘will grow faster than the overall NHS budget’.
However, little detail about how this money will be invested has been communicated through the long term plan, leaving practice managers and GPs perplexed about what the future will hold.
We got the views of five sector experts on the long term announcement.
Clive Elliott – business partner at Court Street Medical Practice in Telford and Wrekin CCG
‘[The long term plan] appears to be good news not just for general practice and patient care, but for the NHS more generally. What patients want is the best care in the most convenient location and GP practices are already at the heart of local communities.
‘The devil, as always, will be in the detail, but if hospitals can be persuaded to work with primary care rather than in competition, I believe a different way of doing things could achieve fantastic results.
‘I do have some concern about practices being forced into larger locality groups but if locality groups are given the autonomy to decide local priorities – in agreement with the CCG – and NHS England takes a sensible and fair approach to this, there is no reason why locality groups could not prosper while retaining personalised services and developing their own sub-specialities.
‘I am sure there will be a large number of medics who will be against everything no matter what but, if the NHS is sensible about how it does this, it could be a seminal moment in the life of the service. However, just issuing diktats from Whitehall is not the way forward.’
Richard Miller – practice manager at Great Bentley Surgery, Colchester
‘It’s good that general practice has been recognised as a need, but I do wonder if the additional funding will arrive in the form that will actually help us. The Government seems to think it knows more about what’s needed that those actually working on the front line in the NHS, so I reserve judgement for now.’
Tracy Dell – practice manager at Plane Trees Group Practice, Halifax
‘I am pleased to hear that there will be some investment to set up a rapid response teams of GPs, nurses and physiotherapists to provide urgent care in the community. We employ a MSK advanced clinical practitioner who manages nearly 10% of our patients. We would like to develop this service further to incorporate physiotherapy support to complement existing provision.
‘Having mental health support teams based in schools and colleges will release the pressure in primary care and address some unmet need for our younger patients.
‘Further engagement around the NHS long term plan is crucial to ensure that changes are being implemented and reviewed regularly and ensure improvements are sustained.’
Daniel Vincent – managing partner at Ryalls Park Medical Centre, Yeovil
‘I was delighted to see that patients will be able to access 24 hour mental health crisis care via 111. I have long believed that providing better specialist mental health support for patients will have a significant impact on the availability of GP appointments.’
Val Denton – practice manager at Hillview Family Practice, Bristol
‘I was pleasantly surprised to see that, for a change, primary care was being given money rather than having it taken away.
‘As one of the practices in a highly deprived area, we have seen our funding and investment cut to the bone with the PMS review and the Carr-Hill formula.
‘If this funding does get to us, it will be to replace the swingeing cuts we have had to suffer over a five year period, so it’s a bit ironic that we may be getting some of it back  –but I won’t complain if we do.
‘I hope that for once we won’t need to jump through hoops to get this funding.’
Professor Helen Stokes-Lampard – RCGP chair
‘Family doctors will now want to see the detail of what this means for frontline GPs and their teams over the coming months and years as they deliver care to over a million patients every day.
‘We are pleased to see £4.5bn extra a year earmarked for primary and community care. But it is not clear what precisely this means, and if we are to secure the long-term sustainability of the NHS, we need the share of funding actually going to general practices to also grow.’