Fourth Report - The future of general practice

The government partially accepts, acknowledging access challenges but not a 'crisis'. It details ongoing efforts and specific actions from its Delivery Plan for Recovering Access to Primary Care, including a retargeted investment of over £1bn (up to £645m in community pharmacy, £240m for a new access approach), recruitment of over 29,000 primary care professionals since 2019, and measures to reduce GP bureaucracy.

The government partially accepts, agreeing to explore solutions for primary care constraints but states it does not want to duplicate ongoing work. It points to existing efforts like the Academy of Medical Royal Colleges review, the Delivery Plan for Recovering Access to Primary Care, the 'Bureaucracy busting concordat', and pilots for automating administrative processes.

The government accepts and is adapting GP specialty training distribution to better reflect population needs as part of NHS England’s trainee redistribution programme. It also highlights ongoing efforts like new medical schools and the Targeted Enhanced Recruitment Scheme, which provided £20,000 incentives for training in hard-to-recruit areas, with 800 places available in 2022.

The government partially accepts, acknowledging that ARRS doesn't explicitly cover supervision for all roles but states support creates supervisory capacity for Advanced Practitioners. It commits to reimbursing Primary Care Networks (PCNs) for First Contact Practitioners' training time and has increased the cap on Advanced Practitioners. It also states that inner and outer London weightings are reflected within current ARRS allocations to PCNs.

The government partially accepts, focusing on existing GP retention schemes (National GP Retention Scheme, Fellowship Programme) and exploring flexible working to support retention, while noting that GP partnerships are responsible for reviewing working conditions.

The government accepts the recommendation and states that continuity of care is a priority for Integrated Care Systems, citing existing initiatives like the Modern General Practice Access approach, issued frameworks, and ongoing work to improve digital services and patient communication.

The government partially accepts the recommendation, stating it will reduce QOF and IIF indicators for 2023/24 to address micro-incentives. It also commits to formally consulting on the future of QOF during 2023/24 and engaging with stakeholders on IIF reform.

The government accepts the recommendation for better integrated care, stating NHS England has issued a framework to support access, implemented the Modern General Practice Access approach, begun commercial work to rationalise digital services, and started standardising patient communications.

The government accepts, stating it is a priority for ICSs and outlining initiatives like the Modern General Practice Access approach to improve patient navigation, triage, and access, alongside work on digital services and communication standardization.

The government accepts the importance of giving GPs headspace and back-office support, detailing plans for Integrated Care Systems to implement Fuller stocktake recommendations, providing digital tools and funding through a new delivery plan, and launching a National General Practice Improvement Programme.

The government accepts and outlines several initiatives, including ICS implementation of Fuller stocktake recommendations, digital tools, care navigation training, and the new National General Practice Improvement Programme, to increase organisational support for GPs.