• Deadline for national extended GP access brought forward
  • Coverage target for April 2018 already met
  • GP budgets protected but get no further uplift from newly announced NHS funding

National officials have brought forward the date that all parts of the country will deliver extended GP access hours, after exceeding the target for 2017-18.

NHS England and NHS Improvement, in their updated planning guidance for 2018-19, said all clinical commissioning groups would have extended access for 100 per cent of their population by October 2018.

This is six months earlier than the target set out in Next Steps on the Five Year Forward View last year. 

According to the planning guidance, 52 per cent of the country now has access to extended GP opening hours - beating the target of 50 per cent by April this year.

Provision of extended GP hours includes access to same day pre-bookable appointments after 6.30pm on weekdays and on Saturday and Sunday, depending on population needs. This can be provided on a “hub” basis - ie at a single site shared across a number of GP practices, rather than by each practice. 

There has been controversy over whether there is evidence that there is sufficient demand for the extra hours, and whether it is the best use of money.

Meanwhile, the planning guidance confirms the planned 4 per cent funding growth in the budget allocation for general practice. NHS England’s board paper states this will “enable the expected cost uplifts in the 2018-19 GP contract to be funded, as well as the funding commitments set out in the General Practice Forward View on extended access and investment in estates and technology”.

There will be no further increase for the GP budget following an additional £2.14bn added by government to the NHS England budget, however. It is going to “sustainability” funds to deal with deficits and into CCG allocations with the priorities of emergency care, elective waiting lists, and ensuring mental health spend uplifts are met.

NHS England has also set out a timeline for every GP practice to be working in a “local primary care network”, serving populations of 30,000 to 50,000, during 2018-19.

Although the national commissioner has previously never set out a definitive time line to develop these networks, in March last year Arvind Madan, national director for primary care, told HSJ it would be achieved during 2017-19. 

No changes to the quality and outcomes framework - the GP pay for performance scheme - are mentioned in the planning guidance, despite some discussion of it being replaced.

As part of demands for CCGs to contain activity growth, planning guidance assumes growth in GP referrals of just 0.8 per cent for 2018-19.

It also says there will be an incentive scheme for community providers to help reduce excess acute bed days. The scheme will allow CCGs to “reinvest savings from acute excess bed day costs to expand community and intermediate care services”.