GPs must offer alternative plans to day centers to access funds

The North West London ICB has asked GP practices to develop their own plans to improve access to access funding that had been linked to now-abolished same-day access centers .

But leaders at North West London’s LMC have expressed concern that more than £5 million of funding intended to improve access could be “lost” to general practice due to delays from the ICB.

Pulse exclusively revealed in February that NWL ICB planned to make same-day hubs mandatory by including them in its “one-stop-shop” of enhanced services, meaning practices must commit to the whole package or fail. receive no funding.

In March, when NWL ICB was forced to abandon the controversial plans – due to intense resistance from patients and GPs – it pledged to find a way to redirect the £6.6 million that was due be used for poles towards general medicine.

But local GP leaders fear some of this money will not be used in this way due to a “lack of clarity” over what RSPs should do.

The ICB presented a “refreshed” access improvement plan at a meeting of the local health oversight committee yesterday, where it admitted its initial plans had not been “well received”.

The new plan will still require GP practices to sign up to the full “one-stop deal” in order to receive funding from the wider package of enhanced services in 2025/26.

But rather than imposing a particular same-day access model, the ICB wants RSPs to “co-produce their access models with their member practices and patients”.

The first step towards this is a survey sent to all patients and staff in the region, for which RSPs receive funding of 50p per weighted patient, representing £1.3 million of the total £6.6 million available until the end of this financial period. year.

NWL LMC executives acknowledged that the survey results “could provide practices with meaningful information” but raised concerns about “project timelines” and practice workload.

They also said there was a “lack of clarity” over the next phase of the ICB’s program to improve access, noting that the plan for the remaining £2 per patient has not been finalized nor communicated to the firms.

A briefing pack for yesterday’s scrutiny committee meeting said the next step after the inquiry depends on securing approval for a business case “enabling each PCN area to advocate in for funding to the ICB, to support any plans they may have to improve access.”

To access additional funding, RSPs will need to submit access improvement plans that demonstrate a “return on investment” and are based on patient views.

The ICB document continues: “Areas that have already implemented same-day models may look to expand and develop them further or decide to focus on something different.

“Each area will, however, need to progressively test and test their plans, involve patients in the development and development of their plans, continually evolve and improve what they do, and work to organically improve patient satisfaction with health care. ‘access.”

NWL LMC Network Chairman Dr Chaand Nagpaul told Pulse that the LMC had received “considerable feedback” from PCNs on the “real lack of clarity” in the upcoming specifications and whether the entire funding pot would be used.

He said: “At the moment what concerns us very much is that it is now October and the ICB has taken so long to develop this ‘commitment’ stage – which is 50p per person – leaving the remaining £2 per person. the total of £5 million, missing. In reality, they don’t have any plans yet.

At yesterday’s meeting, Dr Nagpaul asked the ICB to provide assurances on this: “I just want GPs and the general population to clarify (…) that anything that is not used is kept aside for use in general practice, for access and this program, separate from the £6.6 million which will come into use in April 2025.

“We don’t want GPs to lose money due to the current delay and lack of information about stage two.”

ICB CEO Rob Hurd assured Dr Nagpaul and the Health Scrutiny Committee that the total £6.6 million is “reserved” for GP access and “will not be used for other services”, but that its full use this year depends on the outcome of the business case.

Director of Primary Care at the ICB, Javina Sehgal, said: “I just want to reassure the LMC and colleagues around the table that the money is for access, the ICB has no no intention of using this money for anything else.

Regarding the details of how PCNs will access this money, she said: “Depending on the proposals that come forward, we have told all of our PCNs that they can get up to £2 per registered resident to deliver and our intention has always been to continue. this would involve spending £2.50 per head, which equates to £6.6 million.

A group of local patient representatives, who spoke out about initial plans for same-day drop-in centers earlier this year, wrote to Health Secretary Wes Streeting raising “major concerns » regarding ICB projects.

In a letter seen by Pulse, they said “it is unclear whether same-day access is an essential part” of the ICB’s new proposals on GP access.

Regarding the patient surveys, which began last week, he said: “The ICB, through the NHSE, already has the required data submitted by GPs on access/appointments, which should show which firms are “doing very well” and which are “less performing”. GOOD”.

“We do not understand why the ICB does not organize support for the least efficient practices when they potentially risk destabilizing good practices.”

More broadly on the plans, the patient groups said: “Due to the lack of clarity from the North West London ICB on what they are trying to achieve, we fear that at the end of This process we have reduced contact with our GP practices and even less. with a named GP, but we find ourselves referred to undesirable “hubs”.

In February, NHS England’s director of primary care said she wanted to “step back” and let local systems pursue proposals to overhaul same-day access to GPs.

But NWL CEO Mr Hurd then argued that large-scale, same-day access was a “national imperative” and therefore the ICB would not carry out public consultations on its plans.

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