The future of General Practice

Health and Social Care Committee Closed Inquiry
Opened: 16 Nov 2021 Closed: 24 Jul 2023 Parliament page
The Committee has launched a new inquiry to explore the future of NHS general practice, examining the key challenges facing general practice over the next five years as well as the biggest current and ongoing barriers to access to general practice. General practice has seen significant changes in recent years, … Read more
20 Recommendations
25 Conclusions
1 Report
4 Oral sessions
2 Letters
4 Events
Activity timeline 12 events
24 Jul
2023
Report published
11 Jan
2023
Correspondence
20 Oct
2022
Report published
6 Sep
2022
Correspondence
12 Jul
2022
Oral evidence
12 Jul
2022
Formal meeting (oral evidence session) · Room 6, Palace of Westminster
14 Jun
2022
Oral evidence
14 Jun
2022
Formal meeting (oral evidence session) · Room 16, Palace of Westminster
18 May
2022
Oral evidence
18 May
2022
Formal meeting (oral evidence session) · Room 15, Palace of Westminster
15 Mar
2022
Oral evidence
15 Mar
2022
Formal meeting (oral evidence session) · Room 8, Palace of Westminster
Oral evidence sessions 4 sessions
12 Jul 2022
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Dr Amanda Doyle · NHS England Dr Nikki Kanani · NHS England James Morris MP · Department of Health and Social Care Matthew Style · Department of Health and Social Care
14 Jun 2022
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Beccy Baird · King's Fund Dr Margaret Ikpoh · Royal College of General Practitioners Dr Peter Holden · Imperial Road Surgery Mrs Heather Randle · Royal College of Nursing Professor Mike Holmes · Haxby Group Sir Robert Francis QC · HealthWatch England
18 May 2022
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Dr Jacob Lee · Horfield Health Centre Dr Kate Sidaway-Lee · St Leonard's Medical Practice Dr Pauline Grant · Cheviot Road Surgery Dr Rebecca Rosen · Nuffield Trust Professor Steinar Hunskår · University of Bergen
15 Mar 2022
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Dr Andrew Green, Retired GP Dr Becks Fisher · The Health Foundation Dr Kate Fallon · Somerton House Surgery Dr Kieran Sharrock · British Medical Association (BMA) Professor Martin Marshall · Royal College of General Practitioners
Title HC No. Published Items Response
Fourth Report - The future of general practice HC 113 20 Oct 2022 45 Responded
Recommendations & Conclusions
18 results
Clear
3 Recommendation Deferred
Fourth Report - The future of gene…
Commission a review into short-term problems constraining primary care, including IT and administrative tasks.
The Government should commission a review into short-term problems that constrain primary care including, but not limited to: the interface between primary and secondary care, prescribing from signing to dispensing, administrative tasks e.g. reports and sick notes, day-to-day usability of … Read more
Government Response
The government partially accepts the recommendation but shifts focus entirely from commissioning a review into short-term operational problems to discussing increases in GP speciality training places and changes to training duration (from 18 to 24 months in general practice).
Department of Health and Social Care
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5 Recommendation Deferred
Fourth Report - The future of gene…
Provide funding for 1,000 additional GP training places and extend the scheme to four years.
The Government should provide the funding necessary to create 1,000 additional GP training places per year and consider extending the GP training scheme to four years, to allow GP trainees more time to develop their skills in practice as well … Read more
Government Response
The government partially accepts but redirects the focus from increasing GP training places and extending training duration to the Additional Roles Reimbursement Scheme (ARRS). It commits to increasing ARRS flexibility by adding new reimbursable roles, increasing caps on Advanced Practitioners, and removing caps on Mental Health Practitioners as part of the March 2023 GP contract changes.
Department of Health and Social Care
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6 Recommendation Deferred
Fourth Report - The future of gene…
Identify mechanisms to distribute GP trainees equitably and incentivise settlement in under-doctored areas.
The Government and NHS England should identify mechanisms to distribute GP trainees more equitably across the country so that under-doctored areas receive a balanced proportion of domestic and international GP trainees. The Government should explore schemes that incentivise GP trainees … Read more
Government Response
The government accepts the recommendation but deflects by addressing the role of receptionists and care navigation training instead of GP trainee distribution and incentives. It commits to investing in a new National Care Navigation Training programme for up to 6,500 staff rolling out from summer 2023, and introducing a Quality and Outcomes Framework module focused on optimising demand in general practice.
Department of Health and Social Care
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8 Recommendation Deferred
Fourth Report - The future of gene…
Set out plans to increase flexibility of ARRS for diverse local hiring.
NHS England should set out how it plans to increase the flexibility of the Additional Roles Reimbursement Scheme to allow Primary Care Networks to hire both clinical and non-clinical professionals other than those set out in the current guidance, according … Read more
Government Response
The government partially accepts but deflects by focusing on e-prescribing in hospitals and the interface between general practice and hospitals. It rejects a national mandate for a standardised reporting tool, stating that Integrated Care Boards should decide their own approaches to improving communication and local pathways.
Department of Health and Social Care
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9 Recommendation Deferred
Fourth Report - The future of gene…
Provide standardised national training for primary care receptionists to enhance patient navigation.
Receptionists play an incredibly important role in primary care that often goes unrecognised. Given they are often the first point of contact with primary care for most patients, NHS England should review and consider providing standardised national training to drive … Read more
Government Response
The government partially accepts the recommendation but deflects by focusing on exploring opportunities for automating processes in general practice to free up clinical capacity. It highlights ongoing support for two pilots testing automated coding of bowel screening results and other administrative processes in London.
Department of Health and Social Care
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10 Conclusion Deferred
Fourth Report - The future of gene…
Need to explore ARRS uplift for non-staff costs and weighted salaries.
The Government and NHS England should explore the possibility of providing an uplift to the Additional Roles Reimbursement Scheme to support non-staff costs such as supervision and training or to provide weighted salaries in areas where the cost of living … Read more
Government Response
The government's response discusses ongoing work and future plans for improving primary care IT systems, digital consultation tools, and cloud-based telephony, which bears no relation to the recommendation regarding Additional Roles Reimbursement Scheme (ARRS) uplift or Agenda for Change terms.
Department of Health and Social Care
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13 Recommendation Deferred
Fourth Report - The future of gene…
Fund research into machine learning for automating general practice clinical administration.
The Government should also fund research into the specific role that machine learning can play in the automation of reporting and coding test results to reduce clinical admin in general practice.
Government Response
The government's response outlines changes to pension arrangements, including increasing the annual allowance, abolishing the lifetime allowance, and introducing retirement flexibilities, which is entirely unrelated to the recommendation about funding machine learning research for admin reduction.
Department of Health and Social Care
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14 Recommendation Deferred
Fourth Report - The future of gene…
Undertake full review of primary care IT systems to improve clinician user interface.
The Government should undertake a full review of primary care IT systems from the perspective of the clinicians with an emphasis on improving the end user interface. Making the working life of each clinician that bit easier will drastically improve … Read more
Government Response
The government's response discusses the importance of continuity of care, the named GP policy, the Fuller Stocktake, and the role of multi-disciplinary teams, which bears no relation to the recommendation for a review of primary care IT systems.
Department of Health and Social Care
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15 Conclusion Deferred
Fourth Report - The future of gene…
NHS staff should not be forced into locum work or inter-practice competition.
As we said in our recent Report on the NHS workforce, no NHS employee should be forced to choose to locum or work for an agency to regain control over their working The future of general practice 41 life. This … Read more
Government Response
The government partially accepts, stating they will introduce methods to promote continuity of care and consider how best to measure it, but will not commit to a specific measure by 2024, which is unrelated to the committee's recommendation on locum work and staff competition.
Department of Health and Social Care
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18 Conclusion Deferred
Fourth Report - The future of gene…
Prohibitively expensive pensions tax bills disincentivize older GPs from remaining in practice.
Older GPs continue to face prohibitively expensive pensions tax bills which act as a significant disincentive to them staying in practice. Efforts taken to date to reduce the impact on GPs have not been sufficient to prevent experienced GPs from … Read more
Government Response
The government rejects the recommendation, stating that it does not accept it because the size and skills mix of the workforce are matters for individual general practices to determine, which is unrelated to the recommendation on GP pension tax bills.
Department of Health and Social Care
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19 Recommendation Deferred
Fourth Report - The future of gene…
Adopt recommendations on NHS pensions, accounting for GP partners and supporting practices.
The Government and NHS England should adopt the recommendations related to NHS pensions in our recent Report on Workforce: recruitment, training and retention in health and social care. In developing short and long-term solutions to the NHS pensions issue the … Read more
Government Response
The government rejects the recommendation by referring to its response to recommendation 17 (which concerned continuity of care models) and reiterates plans to promote the RCGP’s Continuity of Care toolkit, thereby failing to address the substance of NHS pensions for GP partners.
Department of Health and Social Care
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23 Conclusion Deferred
Fourth Report - The future of gene…
Government and NHS England must acknowledge declining continuity of care and prioritise its reversal.
The Government and NHS England must acknowledge the decline in continuity of care in recent years and make it an explicit national priority to reverse this decline.
Government Response
The government partially accepts the recommendation but discusses current and ongoing work to explore gain sharing agreements and financial incentives to reward primary care for reducing secondary care expenditure, rather than making continuity of care an explicit national priority.
Department of Health and Social Care
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24 Conclusion Deferred
Fourth Report - The future of gene…
Routine measurement of continuity of care is essential for improvement efforts and targeted support.
Unless continuity of care is routinely measured GP practices and Primary Care Networks will be unable to identify where to focus improvement efforts. NHS England will also be unable to effectively target support without establishing a baseline for the provision … Read more
Government Response
The government partially accepts but deflects the recommendation, discussing existing funding mechanisms like the Carr-Hill formula, which it states will not be changed until the end of 2023/24, instead of addressing the routine measurement of continuity of care.
Department of Health and Social Care
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25 Conclusion Deferred
Fourth Report - The future of gene…
National continuity of care measure required for all GP practices by 2024.
NHS England should introduce a national measure of continuity of care to be reported by all GP practices by 2024. The new measure should be based on existing models such as the Usual Provider Continuity Index and the St Leonard’s … Read more
Government Response
The government accepts the recommendation but discusses existing and upcoming organisational support initiatives for Primary Care Networks and practices, including digital tools, care navigation training, and the National General Practice Improvement Programme, rather than committing to a national measure of continuity of care by 2024.
Department of Health and Social Care
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26 Conclusion Deferred
Fourth Report - The future of gene…
Additional funding required for continuity leads and administrative staff in Primary Care Networks.
NHS England should provide Primary Care Networks with additional funding to appoint a ‘continuity lead’ for at least one session per week, and additional admin staff funding to support the lead in the role. The role of the continuity lead … Read more
Government Response
The government partially accepts the recommendation but discusses its commitment to the partnership model and existing investments in general practice funding through various schemes, without addressing the specific request for additional funding for PCN 'continuity leads'.
Department of Health and Social Care
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27 Conclusion Deferred
Fourth Report - The future of gene…
Personal lists are essential for improving continuity of care in NHS general practice.
Personal lists are the best way to deliver continuity of care and are therefore an essential component of improving the levels of continuity provided in NHS general practice. We recognise the pressures in general practice but we believe that delivering … Read more
Government Response
The government partially accepts but deflects the recommendation, discussing challenges related to GP premises, property ownership, and how primary care infrastructure can be supported through the planning system, including updating relevant guidance.
Department of Health and Social Care
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28 Conclusion Deferred
Fourth Report - The future of gene…
NHS England's crucial role championing personal list model and setting 2027 ambition.
As part of wider efforts to improve continuity of care NHS England should champion the personal list model rather than dismissing it as unachievable. NHS England should set a stretching ambition that by 2027 80% of practices have returned to … Read more
Government Response
The government partially accepts but deflects the recommendation, stating it needs further exploration before committing to accelerate plans to allow GP partners to operate as Limited Liability Partnerships (LLPs), citing concerns about legal and financial risks and low take-up in Scotland.
Department of Health and Social Care
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45 Recommendation Deferred
Fourth Report - The future of gene…
Accelerate plans for GP partners to operate as LLPs to limit financial risk exposure.
The Government should accelerate plans to allow GP partners to operate as Limited Liability Partnerships or other similar models which limit the amount of risk to which GP partners are exposed. (Paragraph 144) 46 The future of general practice
Government Response
The government partially accepts but defers action, stating further exploration is needed regarding the impact on NHS England and government before committing to accelerate plans for Limited Liability Partnerships.
Department of Health and Social Care
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Government Response AI assessment · 45 of 20 classified
Accepted 11
Accepted in Part 7
Acknowledged 3
Deferred 18
Rejected 6
Total 20 recs + 25 conclusions
Correspondence 2 letters
11 Jan 2023 To committee Letter from the Parliamentary Under Secretary of State for Primary Care and Public Health (HSCC Report - The Future of General Practice) 23.12.22
Parliament page
6 Sep 2022 Correspondence from the Parliamentary Under Secretary of State for Primary Care and Patient Safety on the Future of General Practice dated 28.08.22
Parliament page