My Lords, I shall now repeat a Statement made in another place:
“Madam Deputy Speaker, with permission, I would like to make a Statement on the primary care recovery plan. For most of us, general practice is our front-door to the NHS. In the last six months, over half the UK population has used GP services, and GPs in England carry out around 1 million appointments every single day. They are doing more than ever. General practice is delivering 10% more appointments a month than before the pandemic; the equivalent of the average GP surgery sees an additional 20 patients every working day. There are more staff than ever, with numbers up by a quarter since 2019, and we are on track to deliver our manifesto target, with an additional 25,000 staff already recruited into primary care. We are investing more than ever, too, with the most recent figures showing that funding was around a fifth higher than five years before, even once inflation is taken into account.
But we know that there is a great deal still to do. Covid-19 presented many challenges across the health service, leaving us with large numbers of people on NHS waiting lists, which need to be tackled. In general practice, patient contacts with GPs have increased between 20% and 40% since the pandemic. As well as recovering from the pandemic, we face longer-term challenges, too. Since 2010, the number of people aged 70 and above has increased by a third, and this group attends five times more GP appointments than young people. Not only that, but advances in technology and treatments mean that people understandably expect more from primary care systems.
Today I can announce our primary care recovery plan, and I pay tribute to my honourable friend the Member for Harborough for this plan. I have deposited copies of the plan in the Libraries of both Houses. Our plan will enable us to better recover from the pandemic, to cut NHS waiting lists and to make the most of the opportunities ahead by focusing on three key areas: first, tackling the 8 am rush by giving GPs new digital tools; secondly, freeing up GP appointments by funding pharmacists to do more, with a Pharmacy First approach; and, thirdly, providing more GPs’ staff and more appointments. NHS England and my department have committed to make over £1.2 billion of funding available to support the plan, in addition to the significant real-terms increases in spending on general practice in recent years. Taken together, our plan will make it easier for people to get the help they need.
The plan builds on lots of other important work. Last year, we launched the elective recovery plan, which is making big strides to reduce the backlog brought by Covid-19. We eliminated nearly all wait lists over two years by last July, and 18-month waits have now decreased by over 90% since their peak in September 2021. By contrast, in the NHS in Labour-run Wales, people are twice as likely to be waiting for treatment than in England. They still have over 41,000 people waiting over two years and nearly 80,000 waiting over 18 months.
In addition, this January, I came before the House to launch our urgent and emergency care plan, which is focused on how to better manage pressures in emergency departments, with funding to support discharge to improve patient flow in hospitals. Today’s plan is the next important piece of work.
Turning to the detail of the plan, our first aim is to tackle the 8 am rush. We will do this by providing GPs with new and better technology, moving us from an analogue approach to ways of working in the digital age. An average-sized GP practice will get 100 calls in the first hour of a Monday morning, but no team of receptionists, no matter how hard-working, can handle such demand. About half of GPs are still on old analogue phones, meaning that when things get busy, people get engaged tones. We are changing this by investing in modern phone systems for all GPs, including features such as call-back options, and by improving the digital front-door for even more patients. In the GP practices that have already adopted those systems, there has been a 30% improvement in patient feedback on their ability to access the appointments they need. This also reflects the fact that online requests can help find the right person within the practice, such as being directed to a pharmacist for a medicine prescription review or to a physio for back pain.
In doing so, we will make the most of the 25,000 more staff we now have in primary care. Today’s plans fund practices without this technology to adopt it, while also providing them with staff cover to help them manage a smooth transition into this technology. Indeed, many small GP practices find it hardest to fund new technology, or to manage the disruption that comes with transitioning to new ways of working, so we are funding locum cover alongside the tech itself. Notwithstanding that, people will always be able to walk in or ring if they prefer; if someone wants to ring up and see someone face to face, these investments will make that easier, too.
We also want to make sure that patients know how their request is going to be handled on the same day that they make contact. Clinically urgent issues will be assessed on the same day, or the next day if raised in the afternoon. If the issue is not urgent, an appointment will be scheduled within two weeks, but, crucially, people will not be asked to call back tomorrow. Instead, they will get their appointments booked on the same day or be signposted to other services.
The second area of this plan is Pharmacy First. As well as giving GPs new technology, I know that we need to take pressure off GPs where possible by making better use of the skills of all clinicians working in primary care. We saw the incredible role that pharmacists played during the pandemic—their capacity to innovate and deliver for the communities that they served, freeing up GP appointments in doing so—so the second part of our plan is to introduce a new NHS service, Pharmacy First, on which we are already consulting with the Pharmaceutical Services Negotiating Committee.
Some 80% of people live within a 20-minute walk of a pharmacy, so making it easier for pharmacists to take referrals can have a huge impact. Referrals might be from GPs, NHS 111 or, from next week, urgent and emergency care settings. Community pharmacists already take referrals for a range of minor conditions, such as diarrhoea, vomiting and conjunctivitis, but with our Pharmacy First approach we can go further still. We will invest up to £645 million over the next two years so that pharmacists can supply prescription-only medicines for common conditions, such as ear pain, UTIs and sore throats, without requiring a prescription from a GP.
One of the most significant shifts we are making is in oral contraception. Pharmacists can already manage the supply of contraception prescribed elsewhere; from later this year, they will also be able to start women on courses of oral contraception. This is another way in which we aim to reduce the barriers to women accessing contraception, in light of our women’s health strategy. Pharmacists will also be able to do more blood pressure checks, which is one of the most important risk factors for cardiovascular disease. Not only will those kinds of steps make it easier for people to get the care they need; we expect that they will release up to 10 million appointments a year by 2024-25.
The third part of our plan is about providing more staff and more appointments. We are making huge investments in our primary care workforce, and are on track to meet the manifesto commitment of 26,000 more primary care staff by next March, meaning that we have more pharmacists, physios and paramedics delivering appointments in primary care than ever before. In 2021, we hit our target of 4,000 people accepting GP training places, and our upcoming NHS workforce plan will set out how we will further expand GP training. We are also helping to retain senior GPs by reforming pension rules, lifting 9,000 GPs out of annual tax changes. These are the pension reforms that the British Medical Association welcomed, describing them as ‘significant’ and ‘decisive’ changes and citing them as ‘transformative for the NHS’.
As well as freeing up more staff time, our plan cuts bureaucracy, too, so that GPs spend less time on paperwork and more time caring for patients. We will remove unnecessary targets, improve communication between GPs and hospitals, and reduce the amount of non-GP work that GPs are being asked to do. For example, patients are often discharged from hospital without fit notes, meaning that they then have to go to their GP to get one. By the end of this year, NHS secondary care services, which understand those patient conditions better, will be able to issue fit notes, and we have streamlined the number of targets on primary care networks from 36 down to just five. Taken together, this work will free up around £37,000 per practice.
Today’s primary care recovery plan funds and empowers our GPs and pharmacists to do more, so that we can prevent ill health, keep cutting NHS waiting lists and improve that vital front door to the NHS for many millions of people. I commend this Statement to the House.”