Earlier this year the NHS announced it GP Forward View, a series of measures aimed at relieving the workload pressures on GP practices and primary care. Fast forward a few months and we are now seeing a number of the promised measures being turned into reality.

One of those realities is the roll-out of the ‘Releasing Time for Patients’, which it was announced this week will commence in practices in North East Staffordshire.

What is it?

The three-year programme has been designed to release 10% of GPs’ (and other practice staff) time. A budget of up to £30m has been set aside for the national roll-out, which will focus on 10 ‘high impact actions’ in practices, including group consultations, increasing the use of other healthcare professionals and reducing DNAs.

What does it involve?

The most informative documentation we’ve seen regarding the programme is the invitation sent to GP practices in North East Staffordshire inviting them to a meeting about it next month.

It said that the NHS England ‘sustainable improvement team’ would work with all local practices to “review their business processes with a view to implementing change” with the team offering training and support.

“This is an excellent opportunity for all practices to benefit from a specially-tailored programme designed to support and enable them to make changes, which will improve efficiency, release time and aid future sustainability,” it said.

What are the 10 actions?

According to the NHS GP Forward View, the 10 high-impact actions are:

1. Active signposting – online portal and reception navigation
2. New consultation types – telephone, e-consultations, text message, group consultations
3. Reduce DNAs – easy cancellation, reminders, patient recording, read-back, reporting attendances, reduce ‘just in case’
4. Develop the team – advanced nurse practitioner, physician associates, pharmacists, medical assistants, paramedics, therapists
5. Productive work flows – matching capacity and demand, efficient processes, productive environment
6. Personal productivity – personal resilience, computer confidence, speed reading, touch typing
7. Partnership working – productive federation, community pharmacy, specialists, community services
8. Social prescribing – practice based navigators, external service
9. Support self care – Prevention, acute episodes, long term conditions
10. Develop QI expertise – leadership of change, process improvement, rapid cycle management, measurement

The main components proposed for the programme are:

Innovation spread: a national programme to gather and disseminate successful examples and measure impact. This will include support on implementation of the 10 high impact actions, and a specific focus on addressing inequalities in the experience of accessing services, where there are national trends.

Service redesign: locally hosted action learning programmes with expert input, supporting practices and federations to implement high impact innovations which release capacity and improve patient care.

Capability building: investment and practical support to build change leadership capabilities in practices and federations, enabling providers to improve quality, introduce care innovations and establish new arrangements for the future.

A case study

An idea of what to expect from the programme has been published in the GP Forward View:

In the Better Local Care (Southern Hampshire) vanguard, four practices have created a Same Day Access Service (SDAS) which pools the same day primary care workload and workforce for the four practices into a single service, operated from a central location at Gosport War Memorial Hospital.

The SDAS operates from 8am-7pm, Monday – Friday. Patients call their own surgery and those who require same day advice or care are managed in the SDAS. Of 5,500 patients referred to the service in its first six weeks of operation, 3,350 (61%) were able to have their needs met on the telephone. The remaining 2,150 patients attended a face-to-face SDAS consultation. The face-to-face consultation service is staffed by GPs, emergency nurse practitioners, paediatric nurses and practice nurses.

The initiative has contributed to greater GP availability in the practices; better working conditions for practice staff; longer appointments available for patients with complex needs; and reduced waiting time for routine appointments.

What are the ideas based on?

Much of the work being done through this programme is based on the results of the 2015 Making Time In General Practice study by the Primary Care Foundation. More information on this can be found by clicking the link.

Other feedback and ideas has been provided by CCGs and pilot practices that have been used to trial the scheme.

How can I be a part of it?

Practices wanting to benefit from the programme need to register an expression of interest, which can be done by completing the Expression of Interest form. Four steps are involved in the registration:

1. Submit Expression of Interest – A development advisor will make contact within 4 weeks to begin designing your programme with you.
2. Planning & preparation – Building partnerships and plans for your change programme. Beginning optional extras.
3. Time for Care programme – A 9-12 month programme of collaborative service redesign to release time for care. Knowledge exchange with other practices nationally, expert facilitation in service redesign, peer sharing and support. Optional extras including QI training, reception & clerical staff training, The Productive General Practice, online consultation systems and local development support.

Expressions of interest can be submitted at any time, with a final cut-off date of August 2018.

Where can I read more?

Further information can be obtained from the relevant web page – which can be found here.

Here at Practice Index we’re looking forward to finding out more when the first meeting of North East Staffordshire practices take place. Only then will we know if the actions within the programme will really make a difference to practices. Watch this space for more information!

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