Health Management and Policy Alert

Patients first: why general practice is broken and how we can fix it

British Medical Association - 
Across England, practices are working at an unprecedented level of activity with daily appointments running at almost 1.5 million. Despite this, the value of funding into the national contract is at a nadir with GP practices receiving 5.5p in every NHS pound. This report details suggested changes that need to happen to stop the loss of local practices, to retain experienced NHS GPs in their surgeries, and to fund practices to take on more GPs and more practice nurses to deliver more appointments.

• Report
• British Medical Association - publications

Balancing supply and demand in primary care: how will the “family doctor” evolve to meet growing demand?

Frontier Economics - 

This research identifies that demand for GP services is likely to rise by about 33% by 2034, compared to a baseline in 2015 when GP statistics were first made publicly available. Planned increases to GP numbers alone will not be sufficient to close this gap, highlighting the critical importance of supplementing GP numbers with a range of other trained staff. A visit to the family doctor will look different for many. One test of the new long term plan will be its ability to meet these challenges.

• Report
• Press release 

An audit of practice education infrastructure for specialist community public health nurses (SCPHN) in Greater London

Institute of Health Visiting - 

Specialist community and public health nurses (SCPHN) in health visiting and school nursing have decreased by more than 40 per cent in England and London is one of the hardest hit areas. The aim of this project was to identify at two separate time points: The ‘state of learning’ for SCPHN students and practitioners within London community settings. The audit, delivered by an electronic survey, sought evidence on the existing education infrastructure and, thereby, learning culture. Whether investments in practitioner development had been matched with an upturn in the organisational learning culture and overall infrastructure to support learning.

• Report
• More detail

Primary care patient safety strategy

NHS England - 

This strategy outlines the primary care implementation of the NHS Patient Safety Strategy, and is for all areas of primary care, though with some improvements implemented first in general practice to enable the successes and learning to be used in the rollout to community pharmacy, optometry and dental services.

• Strategy
• More detail

 

Pharmacy closures in England

Healthwatch England - 

Healthwatch England sent a Freedom of Information (FoI) request to all 42 integrated care boards (ICBs) in England to investigate the issue of pharmacy closures. The briefing provides a geographical breakdown of pharmacy closures in England and finds the closures are hitting older people and rural communities the hardest. Healthwatch England makes recommendations to reduce the impact of pharmacy closures on pharmacy users.

• Briefing
• Press release

Prescription for prevention: supplementary paper — a new funding model for primary care

Reform - 

Learning from funding models in other countries, a future model of primary care contracting would need to reflect three key principles: incentivise outcomes rather than activity, focus on population groups rather than disease pathways, and enable long-term planning. This supplementary paper sets out different options for contracting services and suggests how, in the long-term, budgets could be devolved and pooled to create a genuinely sustainable and preventative system of primary care.

• Paper
• More detail

Prescription for prevention: supplementary paper — a digitally enabled model of primary care

Reform - 

This supplementary paper outlines the steps needed to create the conditions for a technologically sophisticated primary care system while getting the basics right.

• Paper
• More detail 

Prescription for prevention: a new model of primary care

Reform - 

This paper sets out a new vision for primary care. Rather than simply calling for workforce growth or bigger GP appointment targets, it sets out a variety of interventions on estates, workforce composition, technology, regulation, and funding models. These are oriented around three core principles: to intervene earlier, respond faster, and avoid decline – all supported by a new technology and funding infrastructure (which are covered in two supplementary papers).

• Paper
• More detail

 

Cervical screening, my way: women's attitudes and solutions to improve uptake of cervical screening

Healthwatch England - 

In 2023, NHS England set a target to eliminate cervical cancer by 2040. This goal is set against declining levels of uptake by women of cervical screening over the past 20 years. This report investigates why some women are hesitant to go for screening and makes recommendations to policy makers on how to improve uptake and help meet the elimination goal. 

• Report
• Press release 

The impact of hardship on primary schools and primary and community healthcare

Joseph Rowntree Foundation -
This report asks what impact hardship is having on the delivery of services in primary schools and primary and community health care settings such as GP surgeries. It finds that people going without essentials piles pressure on services, diverting resources and adding to workloads and calls for an urgent action plan for hardship.

• Report