Maureen Baker: Implementing the GP Forward View – the first six months of implementation

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Professor Maureen Baker, Chair, Royal College of General Practitioners, discusses funding needed to deliver the GP Forward View, and how RCGP ambassadors are working with sustainability and transformation plans (STP) footprint leads to influence local planning activity and implementation of the Forward View.

This presentation was filmed at our conference, Emerging models of primary care, on 18 October 2016.


We believe, in RCGP, the GP Forward View is the right plan. A key commitment is the funding commitment so that by 2020/21 there will be an additional 2.4 billion a year returned and that’s a 14% increase in real terms.  Okay, so that is the level of funding that is needed to restore general practice, the service of general practice to where it needs to be.  And there is a commitment in Forward View that central funding from NHS England for general practice will be at least 10% but the result of commitment that in addition to the central funding, there will also be local funding and our calculations are that when that’s factored in, then that should take the share of NHS spending in general practice to 11% which is what we’ve been campaigning for.

How we’re going to keep general practice alive, to get to the stage where all this investment and support comes in and part of that is addressed by sustainability and transformation fund, which is the £500 million, five year fund.

There are also a number of other important commitments to address the struggles that we have in general practice at the moment. So I’ll point specifically to the £40 million resilience fund which is starting to be released.  So, this is our analysis of the funding here for general practice of NHS spend since 2003.  We hit a high point, it didn’t seem like it at the time back in 2005, we did hit 11% and since then as you see, steady decrease, levelled off a little bit over the last few years.  If we’d continued on the historic trends a continued decline, I’m quite convinced that that would have spelt the end of general practice.

The purple line factors in the commitment from general practice Forward View, including the intention that local health economies invest in general practice and that gets us up to just under 11%.

So we’ve got the pledges. Is it going to happen?  We’ve pledged to our membership that we will undertake continuous monitoring of what is happening in Forward View and we’re doing this already.  As I say, we have a financial analysis.  We sit on the oversight group of a range of partners who, and the task of that group is to hold NHS England to account for a delivery of their pledges.  And we also have a role in, definitely in influencing so I’ve spoken several times about the intention that there will be funding from local health economies to support the General Practice Forward View the service of general practice, and actually if we just sit back and wait for local people to think “oh yes we will invest in general practice, what a good idea”, we’ll probably see not a penny.  We have to be out there, making it clear that local health economies are mandated to support general practice.

There are opportunities in helping to deliver collapse of the Forward View, so we do want to be engaged in the resilience work and there are other areas where we hope the college can be involved in delivery.

Talked about local investments, sustainability and transformation footprints, and this is the, if you like, the vehicle, for local health economies to come together to plan how they’re going to spend their share of NHS funding over the next five years. We were very worried at the start that there wasn’t much explicit general practice input into those, and we took the step of actually appointing and paying for what we call ambassadors so that we had people who were allocated one or two STPs where they were made known to the STPs and they were supported by NHS England, such that the intention they should be invited to meetings, be able to see and comment in documents and get some influence in there and frankly, they report back to us.

Once their STP plans are published we will checking to see, does this sound right to you, are you going to get the support you need, is the funding that’s committed going to be there and if it’s not we’ll be straight back to NHS England to the Minister in the Department saying “this is what you said, this is what you committed, this is what we’re hearing, it needs to be addressed.”

So thank you very much for your attention. I think there are probably opportunities for questions later and I’ll now invite Jonathan to come and do the next session.


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