Patients will be offered appointments with physiotherapists, pharmacists and “social prescribers” – who can refer patients to non-medical interventions like singing groups - instead of a GP in a bid to address a nationwide doctor shortage and improve access.
A five-year contract agreed between the British Medical Association and NHS this week is being hailed as the biggest overhaul of general practice for more than 15 years by NHS bosses.
Funding for GPs to employ an extra 22,000 non-medical staff, including nurses, are intended to free up GPs to have longer appointments with the most complex patients, such as the frail elderly and those with multiple conditions.
Despite a government pledge to recruit 5,000 more GPs by 2020 numbers have fallen by 1,000 and the contract includes financial incentives to make the job more attractive to new GPs and prevent experienced doctors quitting.
Other provisions include making a quarter of all appointments bookable online and a previously announced “right” for all patients to have Skype-style video appointments.
“This five-year deal unarguably represents the biggest boost to primary care in more than 15 years, giving patients more convenient services at their local GP surgery while breaking down the divide between family doctors and community health services,” NHS England chief executive Simon Stevens said.
NHS England said core funding increases will also support more practice nurses and GPs, with the number of young doctors training to become general practitioners at a record high.
Practices will also have to make one appointment a day available for every 3,000 patients on their list to be directly booked through NHS 111 from April this year.
The BMA said the contract gives practices almost £1bn across five years, while another £1.8bn will be invested to support the formation of primary care networks, in which practices will work together to provide care to patients across a wider geographic area.
Dr Richard Vautrey, BMA GP committee chair, said doctors had weathered a “decade of underinvestment” in the face of shrinking workforce and rising demand.
He said the contract will start to address “unsustainable situation – whereby doctors are choosing to leave the profession while patients wait longer and longer for appointments – and laying the foundations for a general practice fit for the future.”
Richard Murray, chief executive of The King’s Fund, said the changes were welcome, and showed an intention to correct the long-standing imbalance between hospital and GP funding.
But he added: “The timetable for implementing these changes looks extremely challenging.”
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