NHS England has revealed more details about a national pilot to test new ways of working within general practice and ‘further deliver’ on the Fuller stocktake – including which PCNs will be participating.
It was announced earlier this year that ICBs would be launching a scheme looking at different work models and use of technology at PCN and practice level and that would give a number of networks a 10% funding uplift for more clinical staff to ‘accelerate’ delivery of the long-term workforce plan.
The programme is designed to test whether implementing the long-term workforce plan, along with other digital tools such as process automation, can plug gaps in general practice capacity.
The pilot sites, based in seven different ICBs across England, will gather extensive data during the next three years to understand whether these interventions make a difference compared with the current ‘baseline’ and this will help to ‘further deliver’ on the 2022 Fuller stocktake, according to NHS England.
NHS England has said there will be 22 PCNs taking part in the scheme, which are:
- Meridian Health Group (Humber and North Yorkshire ICB)
- Whitby Coast & Moors (Humber and North Yorkshire ICB)
- Holderness Primary Care Home (Humber and North Yorkshire ICB)
- South Hambleton & Ryedale (Humber and North Yorkshire ICB)
- Colchester Medical Group (Suffolk and North East Essex ICB)
- Ranworth (Suffolk and North East Essex ICB)
- Barrack Lane & Ivry Street (Suffolk and North East Essex ICB)
- Tendring (Suffolk and North East Essex ICB)
- Townships 1 (South Yorkshire ICB)
- Rother Valley South (South Yorkshire ICB)
- Seven Hills (South Yorkshire ICB)
- GPA 1 (South Yorkshire ICB)
- Frome (Somerset ICB)
- Mendip (Somerset ICB)
- Cheltenham Central (Gloucestershire ICB)
- Rosebank (Gloucestershire ICB)
- West and Central (North Central London ICB)
- Barnet 3 (North Central London ICB)
- Kentish Town South (North Central London ICB)
- Lincoln Health Partnership (Lincolnshire ICB)
- IMP (Lincolnshire ICB)
- APEX (Lincolnshire ICB)
The commissioner said that at the heart of the plan was ‘a standardised approach that uses digital tools to support triage of requests based on clinical need’ and that the pilot will ‘gather insights on this’.
It added: ‘In practices that have adopted this model, patients have the choice to contact them online, by phone or in person. There are efficiencies in this model.
‘But do these practices now have the capacity to deliver all the proactive and preventative care we ask of them, achieve good levels of care continuity for those who would benefit the most, or be able to lead or contribute to neighbourhood working? If not, what resource is needed?
‘And do patients report positive experiences and staff feel the model is sustainable for them? This programme aims to help answer these questions.
‘The seven ICBs will work with 22 PCN test sites, covering around 1 million patients, to generate the necessary data insights.’
NHS England also said that the programme will begin by establishing a ‘clear data baseline’, as part of a ‘before and after’ approach to test out the changes.
In particular, the pilot will involve:
- ICBs working through the variations in direct and indirect spend on primary care services to ‘understand the impact’ on overall general practice income, capacity and workload.
- PCN test sites conducting three separate audit weeks of ‘intensive’ data collection at the practice and PCN level.
- Gathering of system performance data – data on the activity of 111 calls, A&E attendance and Pharmacy First and requests through referral activity.
- PCN test sites sharing data on the total income and costs for the PCN and each practice, and the proportion focused on GMS/PMS/APMS and PCN DES delivery.
After the baseline has been established, the PCNs will develop changes they want to test and measure the impact of across five possible areas (see box below), and these will then discussed at a workshop in December.
Up to March 2027, the commissioner will provide additional funding to the seven ICBs through adjustments to primary care allocations, and the ICBs will pass most of this funding to PCNs, NHS England added.
NHS England said: ‘Our goal is to support the sustainability of general practice: the bedrock of our NHS.
‘When we first announced the PCN Test Site programme in May 2024, we described how this will help respond to the challenges and pressures that PCNs and their practices are facing.
‘Anecdotal feedback is telling us there is a demand and capacity gap which is making it hard for general practice to continue in a sustainable way.
‘Our aim is to work with general practice to collect the necessary information and data that will give us a better and shared understanding of the gap, the causes and the solutions.’
All PCNs are still set to benefit from the pilot ‘throughout the life of the programme’, according to the NHS England, as ‘learnings will be disseminated widely’.
The BMA GP Committee England and a group of LMCs have highlighted several issues with NHS England’s plan, including its potential to worsen health inequalities and the requirements to share income data.
Initial intervention areas PCNs will test and measure new changes in
- Optimising key aspects from primary care access recovery plan (PCARP)
• Expanding the uptake of the NHS App and Pharmacy First.
• Improving communication to patients about the primary care workforce and digital channels.
• Ways to reduce the workload, clinical and administrative, across the primary-secondary care interface. - Advancing Modern General Practice beyond PCARP
• Implement digital methods for risk stratification and repetitive process automation tools to reduce administrative workload and better utilise resource.
• Achieving higher levels of care continuity for patients who would benefit the most, and how best to measure continuity in modern ways of working. - Enhancing proactive population health management (PHM)
• Implement agreed key actions for effective PHM, such as identifying patient searches for case or medication reviews (e.g. CQC searches, CVDPREVENT reviews, frequent fliers). - Define and apply best practices for MDTs for complex cohorts
• With input from national clinical directors, define and measure the impact of MDTs for complex cohorts by 2025/26. - Increasing clinical capacity
• Funding to increase clinical capacity as outlined in the long term workforce plan for 2028/29 (approximately a 10% increase).
Source: NHS England
A version of this story was first published by our sister title Pulse
