New Operating Models for GP Provision to be tested

Seven integrated care boards are to test new “operating models” for GP provision under a wide-ranging programme backed by NHS England. The scheme will “determine the operational changes and improvements” and “optimise the general practice operating model”, working with selected primary care networks, community services and others, according to a letter from NHS England and a lead integrated care board.

The work will take place over two years, to “enable changes to bed in and the impact and benefits to be studied”, the letter said, with NHSE supporting ICBs and PCNs to “evaluate and systematically capture data, evidence and learning”.

It will determine how to “further deliver” on the Fuller Stocktake report 2022, the letter says, which was the last major NHSE-backed review of the primary care model. It proposed developing integrated neighbourhood-level teams but there has since been little progress on delivering it.

One of the ICBs taking part is Suffolk and North East Essex, whose CEO Ed Garratt will lead the programme, but the others involved have not yet been named.

It comes as general practice battles funding and staffing shortages; high demand; industrial dispute; and controversy over reforms like urgent care hubs and the expansion of non-GP and non-nurse staff. ICBs are under pressure to boost same-day access, with one ICB walking into a row with its GPs over a compulsory same-day urgent “hub” model.

The Labour party has indicated primary care reform and expansion is a priority; and toyed with proposals for radical GP contract reform. 

The programme aims to understand the “optimal use of additional capacity” across different GP services, which is likely to refer to separate clinicans and modes of access from traditional practices. It will look at use of “dedicated” multidisciplinary teams to support patients with complex needs, echoing the Fuller review.

The work will also test “operational changes and digital interventions” — including “more flexible staffing models” and reducing admin — and “develop data-driven insight”, particularly assessing reasons for growth in demand and workload. 

NHSE has agreed to back the scheme, and said the ICBs should “commit reasonable resource” to it, including supporting PCNs to develop robust data and “coordinating input from community services”. NHSE will support it but has committed no funding. 

The pilots will also see ICBs evaluate how primary care can better use digital tools to target the most vulnerable; automate complex processes; and risk stratify populations.

Looks like the 7 ICBs are:

· South Yorkshire

· North Yorks & Humberside

· NC London

· Suffolk & NE Essex (lead)

· Gloucehster

· Somerset

· Lincolnshire