Millions of patients will receive quicker, more convenient access to NHS care from their High Street pharmacies, thanks to a major expansion of services under a radical plan to improve access to primary care.
For the first time ever, patients who need prescription medication will be able to get it directly from a pharmacy, without a GP appointment, for seven common conditions including earache, sore throat, or urinary tract infections by next winter, thanks to government investment of £645 million over two years to expand community pharmacy services.
Published by the NHS and the government, the new blueprint sets out actions to improve access to care, better support patients to manage their own health, and to modernise general practice for future generations.
Almost half a million women will no longer need to speak to a practice nurse or GP to access oral contraception and will instead be able to pop into their local pharmacy for it.
Tens of thousands more people will be at lower risk of a heart attack or stroke, with the NHS more than doubling the number of people able to access blood pressure checks in their local pharmacy – 2.5 million, up from 900,000 carried out last year.
The actions set out in the plan are expected to free up around 15 million GP appointments over the next two years for patients who need them most.
Appointments
Ending the 8am ‘rush’ for appointments is a key part of the plan, with no patient having to wait on hold only to be told to call back another day for help.
This will be supported by investment in better phone technology for GP teams enabling them to manage multiple calls and redirect them to other specialists, such as pharmacists and mental health practitioners, if more suitable. During trials, this has increased patients’ ability to get through to their practice by almost a third.
Extra training will also be provided to staff answering calls at GP practices, so that people who need to see their family doctor are prioritised while those who would be better seen by other staff such as physiotherapists or mental health specialists are able to bypass their GP.
In a significant new step, up to half a million people a year will be able to self-refer for key services, including physiotherapy, hearing tests, and podiatry, without seeing their GP first.
In the run up to the NHS’ 75th milestone birthday on 5th July, the new plan aims to support primary care services to continue to adapt and innovate to meet patients’ needs, with nine in ten people able to access their GP records, including test results, on the NHS App within the next year.
Demand for access is only going to increase with the number of people over 70, who are five times more likely to need a GP appointment than teenagers, growing by a third since 2010.
GP teams are already treating record numbers, with half a million more appointments delivered every week compared to pre-pandemic.
Amanda Pritchard, NHS chief executive said: “The care and support people receive from their local GP is rightly highly valued by patients and so it is essential that we make it as easy as possible for people to get the help they need.
“GPs and their teams are working incredibly hard to deal with unprecedented demand for appointments. But with an ageing population, we know we need to further expand and transform the way we provide care for our local communities and make these services fit for the future.
“Today, we are setting out an ambitious package of measures to do just that – with pharmacies playing a central role in managing the nation’s health including providing lifesaving checks and medication for common conditions for the first time.
“This blueprint will help us to free up millions of appointments for those who need them most, as well as supporting staff so that they can do less admin and spend more time with patients.
“Over the last 75 years, the NHS has always innovated and adapted to meet the needs of each generation and as we approach the 75th birthday, we are doing that for primary care services – providing easy and convenient care as close to home as possible.”
Priorities
Prime Minister Rishi Sunak said: “I am getting on with delivering on my five priorities and transforming primary care is the next part of this government’s promise to cut NHS waiting lists.
“I know how frustrating it is to be stuck on hold to your GP practice when you or a family member desperately need an appointment for a common illness. We will end the 8am rush and expand the services offered by pharmacies, meaning patients can get their medication quickly and easily.
“This will relieve pressure on our hard-working GPs by freeing up 15 million appointments, and end the all-too stressful wait on the end of the phone for patients.”
The plan also commits to further reducing bureaucracy for general practice and building on the work of the Academy of Medical Royal Colleges. Local health systems are being tasked with making fit notes available via text and email to patients, to avoid unnecessary return trips to their GP.
A new review by the Academy of Medical Royal Colleges published today shows how the hospital clinicians and GPs can work together to offer patients more joined up care.
In Lincolnshire and East London hospital clinicians virtually join GP appointments for renal appointments and MSK physiotherapy appointments so elderly patients do not need to trek to hospital.
Joint weekly calls between Enfield GPs and urology clinicians in North London hospitals has also reduced the waiting list by a quarter by joining up care better.
Tools
Health and Social Care Secretary Steve Barclay said: “This plan will make it easier for people to get GP appointments.
“By upgrading to digital telephone systems and the latest online tools, by transferring some treatment services to our incredibly capable community pharmacies and by cutting unnecessary paperwork we can free up GPs time and let them focus on delivering the care patients need.
“Together with further support to increase the workforce, this plan will provide faster and more convenient care.”
Today’s plan will also change local authority planning guidance to mean access to primary care for new residential areas are given the same level of importance as education.
Louise Ansari, CEO at Healthwatch England, said: “The proposals outlined by NHS England are a step-change in how primary care services will be delivered, be it new digital phone systems to prevent people having to stay on hold for long periods of time or training up teams of care navigators to help patients manage GP referrals to other services. What’s more, these changes have been driven directly by people’s feedback and suggestions for improvement.
“When people manage to see a GP or another practice team member, they continue to tell us that the service provided is usually high quality and often very caring. Yet for millions of people, getting that appointment is often made difficult by the early morning scramble for appointments or poorly designed digital booking systems. These frustrations have boiled over in recent years, translating into some of the lowest-ever satisfaction levels with the NHS.
“We know that part of the solution to addressing problems in primary care is to create more capacity, but this will take time. This plan acknowledges that there are actions the NHS can take today to make accessing care easier.
“Over the coming months, we will be working with NHS England to communicate these changes to patients and the wider public, helping them understand how to access the right service at the right time, and feeding back people’s ongoing experience to ensure plans stay on track.”
Community
Janet Morrison, Pharmaceutical Services Negotiating Committee CEO, said: “Thousands of people already rely on their local community pharmacy every day and these new plans from the NHS and Government will allow pharmacies to do even more to help the public from next year. As trusted and expert health and wellbeing resources, pharmacies are ideally placed to do more to help patients and the public to stay well and in doing so to relieve some of the burden on GPs. These plans are a very welcome step towards putting pharmacies even more at the heart of primary care and prevention – where they belong – and making better use of pharmacists’ clinical skills.”
National Pharmacy Association Chair, Nick Kaye said: “We warmly welcome this commitment to invest in a nationwide, pharmacy-based common conditions service, which will improve access to NHS care, free up GP appointments and help cut waiting times for primary care.
“People across England will soon have more convenient access to advice and treatment for common conditions, thanks to the expert support available in their local community pharmacies.
“As trusted and accessible health care professionals, pharmacists and their teams are ideally suited to handle common conditions like coughs, colds and urinary tract infections.
“Everyone will benefit from this development – GP practices, pharmacy teams, the NHS as a whole and, above all, the general public whose day-to-day experience of healthcare will be significantly enhanced by this new service.”
Jacob Lant, Chief Executive of National Voices, said: “GP services are the front door to the NHS, and our first port of call when we feel unwell. So, we are pleased to see big everyday challenges, like the 8am rush, being tackled head-on by this plan. This is something our members, and the people and communities they work with, have called for over a number of years.
“It is also positive to see enhanced use of the NHS App, remote monitoring support and care navigators working front-of-house in practices, to give people more meaningful choices when accessing care.
“By embracing ongoing conversations with people who use services, the NHS can ensure the changes detailed in the plan drive forward the improvements we all want to see, especially around tackling health inequalities, and ensure primary care works for everyone.”
Rachel Power, Chief Executive of the Patients Association, said: “This plan responds to many of the issues we have raised on patients’ behalf over the last few years, and we welcome the changes detailed in it, which will improve patients’ experience of primary care.
“Difficulty getting through to one’s general practice is a major issue for patients. We saw that in our recent survey and hear it on the helpline every day. The steps being taken to prevent the 8am rush to contact GPs reflect suggestions we have made, such as modernising general practice telephony. Patients will be delighted that they no longer have to wait on hold for hours or turn up outside the surgery in the early morning.
“Expanding what you can use the NHS App for and introducing two-way messaging between patients and their GP practice, are positive changes. Patients want easy access to their health records, and being able to do that via the app will benefit millions.
“The plan to fund training of care navigators is excellent news. A trained primary-care based group of workers who can support patients to find the most appropriate professional to help them responds to suggestions we’ve made throughout the pandemic. We think this will really help patients’ timely access to appropriate care.
“The expansion of services within pharmacy is welcome. The local pharmacy is already a source of great information for many patients. Enabling pharmacists to prescribe more and initiate treatments, expands choice for patients.
“Having been part of the transformation board that supported the development of the plan, I’m pleased to see how patients’ concerns have been addressed in it. It’s roll out across the UK will make a big difference to so many people.”
Investment
Professor Aruna Garcea, chair of NHS Confederation’s primary care network advisory group said: “Our primary care network leaders will welcome this plan and the additional investment as an opportunity to support their practices to manage increasing demand for services. Also, our members know that greater use of digital technology enables practices within primary care networks to work together to make the most effective use of their resources and the new roles in primary care. It’s welcome to see a recognition of the role that community pharmacy can play to deliver care for those patients that do not need to be seen in general practice.
“Along with a greater focus on self-care through a national campaign to support people to look after themselves where that is appropriate, we hope that this will go some way to reducing demand on general practice. We look forward to seeing this plan implemented so that primary care can continue to serve local communities as the bedrock of the NHS.”
Malcolm Harrison, the Chief Executive of the Company Chemists Association, said: “We welcome today’s news that the government and the NHS will empower community pharmacies to do more for patients. We see this as a real vote of confidence for the future profession and the community pharmacy sector.
Funding for the contraception service, the Blood Pressure service and for the Common Conditions service is critical to enable delivery. With this investment patients will see an immediate benefit.
We know community pharmacy can take on workload from GPs, thereby increasing access for patients. The initiatives here are a crucial first step in realising the true potential of the community pharmacy sector.
By committing the necessary resource to blood pressure screening, for example, the community pharmacy network has the potential to prevent 15,000 people from suffering heart attacks or strokes by 2026.
We have long been calling for the NHS to allow community pharmacy to play a leading role in urgent care. The access pharmacies offer is essential to tackling health inequalities and meeting a growing patient need. We encourage NHS England to be ambitious in their plans and take full advantage of this opportunity.”
Access
Dr Leyla Hannbeck CEO of Association of Independent Multiple Pharmacies said: “The plan recognises the important role that community pharmacies can play in improving patient access to care. Our communities know us and trust us and for some time, we’ve been arguing that we can be a key solution to many of the challenges facing the NHS and asking the government to put us at the heart of their thinking. Measures to facilitate patient care with less cumbersome and time-consuming bureaucratic burden will be welcome news by pharmacy teams the length and breath of the country.”
Chair of the Royal Pharmaceutical Society in England Thorrun Govind said: “The plans announced today are a real game-changer for patients as they will provide better access to healthcare, helping to reduce the strain on other parts of the NHS and provide patients with the care they need, when they need it. They provide further endorsement of the crucial role that pharmacies play in helping the public at the heart of primary care.
“We welcome the government’s plans that provide additional investment into the sector and that seek to ensure everyone across the country has equal access to care from highly skilled pharmacists and their teams. These plans will help to reduce health inequalities, especially in deprived areas where pharmacies are at the heart of their communities and trusted by patients.
“Providing treatment to help prevent common conditions from becoming worse and requiring more complex treatment later on is better for patients and also cost-effective. Patients can expect to receive trusted advice from pharmacists in their local pharmacy.
“We look forward to working with NHS England, community pharmacies and other pharmacy organisations on the development and roll out of this plan.”
Access the Delivery plan for recovering access to primary care here.
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