Primary care services provide the first point of contact in the healthcare system, acting as the ‘front door’ of the NHS. Primary care includes general practice, community pharmacy, dental, and optometry (eye health) services.
Due to the significant role primary care plays in serving the local population’s health and care needs, there is a large national focus on the continuous development of primary care services, and in particular, the development of general practice.
Practices in Kent and Medway
There are 1.9 million registered patients in Kent and Medway with around 190 GP practices serving them at any one time.
But general practice, like other NHS services, is under significant pressure; both from the pandemic and from the challenges of caring for a growing and aging population with more complex health needs.
The demand across all primary care services, particularly general practice, has risen steadily over the last two years.
Future demand
The population of Kent and Medway is projected to grow by 11.5% (214,000 people) by 2029 and by 19.4% (360,500 people) by 2039. The age bands expected to see the largest growth in the next 10 and 20 years are 65-84 years and 85+.
As people age, they typically develop more long-term conditions that require on-going medical support, with much of this support provided from general practice.
NHS Kent and Medway has developed a plan to support general practice over the next two years to deliver improvements across eight areas. They are:
Access to general practice includes:
- The range of clinical and support roles, and services available
- Opening times and out-of-hours support
- The location of practices together with size and quality of buildings
- Appointment booking processes
- Telephone systems
- Online tools for advice and appointment booking
NHS Kent and Medway is committed to working with practices to improve access. Our aims over the next two years include:
- Using funding, when available, to increase capacity and ensure that practices have robust telephone systems and websites that help patients use online consultations as well as providing information.
- Working with partners to ensure that those who find accessing GP services more difficult are not disadvantaged, and that the required support is available to practices to help them support any such groups.
- Providing more care through community pharmacy to manage the demand on general practice.
- Providing consistent access to appointments / advice using new technology.
- Developing a scheme to tackle the backlog of patient reviews in areas of highest deprivation and in key clinical areas.
- Ensuring that we have joined up approach to tackling access to health for the homeless, ensuring health inequalities are addressed.
- Continuing to support the development of multi-disciplinary teams, reducing the reliance on GPs and ensuring people get to see the right clinician at the right time.
Primary care networks (PCNs) were established in 2019, they are groups of general practices working together.
Find out about the PCNs in Kent and Medway here. They assess the needs of their local population and, working with local community services, make support available to people where it is most needed.
Our aims over the next two years include:
- Increasing the number of additional roles working in general practice, enabling PCNs to create bespoke teams of healthcare professionals.
- Supporting recruitment based on the needs of the population.
- Continuing to work with NHS England, other providers and across PCNs to share learning and development opportunities.
- Providing a better solution for IT/laptop provision for those working in additional roles in primary care.
- Supporting PCNs to tackle health inequalities.
A growing and aging population with increasingly complex health conditions needs a general practice workforce with the numbers and the breadth of skills to help people access the healthcare they need. As the front door to many other NHS services, sufficient capacity and capability in general practice is also key to people getting timely access to the rest of the NHS.
Our aims over the next two years include:
- Ensuring sustainability by sourcing funding through a variety of opportunities.
- Developing initiatives that encourage people to want to live and work in the area, such as coastal fellowships which provide an attractive offer for GPs to work in general practice in areas with higher deprivation.
- Supporting a proactive campaign across Kent and Medway to recruit GPs and the wider primary care workforce and provide recruitment advice, tools and training to support practices.
- Continuing to support Kent and Medway Medical School (KMMS), growing high quality medical school placements in primary care, while supporting practices to develop placement opportunities to expand the future workforce.
- Researching and developing innovative and creative ways to recruit, train and retain additional GPs, nurses and other healthcare professionals.
- Promoting and explaining the benefits of new roles in general practice to improve patients’ confidence and understanding of a multi-disciplinary workforce.
We support quality and safety in general practice through a dedicated team working in partnership with practices and the Care Quality Commission (CQC) as the clinical regulators of general practice.
We are committed to supporting practices to deliver on patient experience and patient safety. Our aims over the next two years include:
- Increasing data analytics support.
- Continuing the development of a data warehouse – a central source of business data to support decision making – to help primary care contribute to patients’ care.
- Continuing to offer a supportive package to practices and primary care networks, promoting best practice sharing and learning.
NHS Kent and Medway has a responsibility to ensure all general practices have sustainable IT support.
Improved use of technology has the potential to extend the range of care general practice can offer and make accessing care more convenient. For our general practice workforce, better technology will help manage pressures and enable them to provide better services to patients.
The Covid-19 pandemic accelerated the adoption of digital technology in general practice. New hardware and software were rolled out at speed to allow general practice to remain open throughout the pandemic.
The new digital tools which have been implemented – such as eConsult– are now a fundamental part of patient access to services and improved resilience of practices through online and video consultation.
While recognising the opportunities that technology offers, we also recognise the issues of digital exclusion and are working to ensure greater use of technology in general practice does not become a barrier for some patients.
We are committed to supporting general practice to use technology to improve the quality and accessibility of their service.
Our main priorities for 2022/23 are:
- Improving access to general practice at scale – including online consultations – as well as communications with patients.
- Promoting adoption of digital services in general practice.
- Transforming general practice services through virtual care, which means measurements such as blood pressure can be digitally monitored remotely.
- Establishing and funding a programme of work to tackle digital exclusion.
Our main priorities for 2023/24 are:
- Introducing new models of digital care which will build resilient services at scale.
- Establishing proactive services for self-help, prevention, and wellbeing.
- Establishing a digitally literate workforce which will help to create capacity, confidence and skills.
- Digitising historical clinical records.
- Giving patients control over their medical record and ensuring clinical professionals have access to shared care records.
Having fit for purpose general practice premises that meet the needs of the workforce and patients is critical.
We will continue to work closely with general practices, PCNs and the Kent Local Medical Committee to develop estate proposals and plans.
Our aims for the next two years include:
- Undertaking site surveys of general practice premises to establish an up-to-date baseline of key information to inform local plans.
- Developing a local approach to using available toolkits and information, to support practices in collaborating to produce estate plans.
- Ensuring maximum gain from notes becoming digitised, helping to unlock ‘space’ in the short to medium term.
- Continuing to engage with local councils regarding local plans and strategic planning.
- General practice will support ‘Delivering a Net Zero NHS’ and this will be further developed over the next two years.
Involving and informing patients in the running of general practice is essential to the effective delivery of primary care services. We are working with practices and the Kent Local Medical Committee to improve how practices engage and communicate with their patients and to promote greater understanding of general practice services.
Our aims over the next two years include:
- Ensuring views of our residents and patients are routinely sought to help shape and inform services.
- Developing a toolkit for engaging with local communities for PCNs and GP practices, supporting practices with advice and training.
- Developing a specification for a standardised website platform for general practice.
- Supporting practices undergoing changes, such as mergers or estates improvements, to engage and communicate with their patients at relevant times.
- Developing a platform to communicate with all practices and support communication across practices.
We are committed to an equitable and consistent approach to funding the core services provided by general practice.
The General Practice and Primary Care Network contracts are funded from the Primary Care Medical allocations. For 2022/23 the overall amount is £308 million (7.1% growth on 2021/22).
Our aims over the next two years include:
- Developing a three-year financial plan to enable the improved monitoring of available resources and help track future commitments.
- Producing a schedule of prioritised investments in accordance with the recommendations of the three-year plan.
- Undertaking research in general practice to deliver evidenced-based improvements in clinical and patient experience, leading to better outcomes and reduced health care costs.
Hear how general practice is changing in Kent and Medway