Improving Access to General Practice in Brighton & Hove – Update Report (January 2025)
1. Introduction
1.1. This report provides members of the Committee with an update on the work being done to improve access to General Practice in Brighton & Hove, following on from previous Primary Care reports presented in April 2023 and October 2023, and includes updates on the Sussex system-level plan around improving GP Access alongside a review of how we are performing on key General Practice access outcomes across Brighton and Hove and what plans we have in place for improving access to general practice.
2. Local Context for Sussex
2.1
NHS Sussex Integrated Care Board (ICB) is responsible for
delivering care to 1.72 million people, across three Places.
Within the three Places, there
are 13 Integrated Community Teams (ICTs). The ICTs will act as the
vehicle to integrate primary, community, social care and the
voluntary sector services within a defined geographical ICT
footprint.
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2.2 Services are largely provided by:
· 156 GP practices and 293 Community Pharmacies
· Two acute Trusts - University Hospital Sussex NHS Foundation (UHSussex), Surrey and Sussex Healthcare NHS Trust (SASH)
· One acute and community health Trust - East Sussex Healthcare NHS Trust (ESHT),
· One specialist Trust - Queen Victoria Hospital NHS Foundation Trust (QVH)
· One community health Trust - Sussex Community NHS Foundation Trust (SCFT)
· One mental health Trust, Sussex Partnership NHS Foundation Trust (SPFT)
· One ambulance provider - South East Coast Ambulance Services NHS Foundation Trust (SECAmb).
2.3 As of October 2024, there are 31 GP Practices in Brighton & Hove, and 51 Community Pharmacies, as well as one Walk In Centre. The total number of registered patients with GP Practices in Brighton and Hove in October 2024 was 333,619 compared to 331,127 in October 2023; an increase of 2492 (0.7%). The registered list sizes of the Brighton & Hove Practices vary from 31,094 at Charter Medical Centre to 1532 at Arch Healthcare.
2.4 The 31 GP Practices in Brighton & Hove are grouped into 6 ‘Primary Care Networks’ (PCNs) which, as set out in the paper presented to HOSC members in October 2023 on PCNs, are non-statutory groups of local neighbouring general practices introduced in 2019 to act as a mechanism for sharing staff and collaborating, typically based around populations of 30,00-50,000 people.
2.5 Table 1 below sets out which GP Practices are members of which PCN in Brighton & Hove:
|
PCN |
Member Practices |
Total List Size (October 24) |
|
Dean’s & Central Brighton PCN |
Brighton Station Health Centre, Saltdean and Rottingdean Medical Practice, School House Surgery, Ship Street Surgery, The Avenue Surgery |
35,888 |
|
East & Central Brighton PCN |
Arch Healthcare, Ardindly Court Surgery, Broadway Surgery, Park Crescent Health Centre, Pavilion Surgery, Regency Surgery, St Peter’s Medical Centre, Wellsbourne Healthcare CIC, Woodingdean Medical Centre |
75,054 |
|
Goldstone PCN |
Charter Medical Centre, Trinity Medical Centre, Wellbeing Healthcare |
80,986 |
|
North & Central Brighton PCN |
Carden & New Larchwood Surgery, Montpelier Surgery, Seven Dials Medical Centre, University of Sussex Health Centre |
42,456 |
|
Preston Park Community PCN |
Beaconsfield Medical Practice, Preston Park Surgery, Stanford Medical Centre, The Haven Practice, Warmdene Surgery |
56,809 |
|
West Hove PCN |
Hove Medical Centre, Links Road Surgery, Mile Oak Medical Centre, Portslade Health Centre, Wish Park Surgery |
42,068 |
Table 1: PCN and General Practices in Brighton and Hove
2.6 General Practices are required to provide essential medical services to people registered with them between 8:00am and 6:30pm Monday to Friday, supplemented by ‘Enhanced Access’ arrangements in each PCN outside of these hours, as well as ‘Out of Hours’ cover commissioned separately.
3 Strategic NHS planning objectives for improving access to General Practice
3.1 Over the past five years, across England, satisfaction with access to General Practice has decreased year-on-year. This decreasing satisfaction, to varying degrees, is observed across multiple domains, including the experience of making an appointment, waiting times for appointments and the type of appointment offered (e.g. whether it is in-person or telephone). Continuing to improve timely access to primary care is a core part of NHS recovery, and central to delivery of the ambitions set out in the Delivery plan for recovering access to primary care.
3.2 To address this, on 9 May 2023, NHS England and the Department of Health and Social Care issued the national delivery plan for recovering access to primary care. This plan built on the findings and recommendations of the Fuller stocktake report and described the Government’s main areas of focus.
3.3 This national delivery plan aimed to address two key objectives:
· to tackle the ‘8am rush’ and reduce the number of people struggling to contact their practice and,
· for patients to know on the day they contact their practice how their request will be managed.
3.4 On the 09 April 24, NHS England published a letter outlining to ICBs the NHS England » Delivery plan for recovering access to primary care: update and actions for 2024/25 which outlines the focus for the second year of delivery against this plan.
3.5 The second year of the delivery plan for recovering access to primary care focusses on realising the benefits to patients and staff, building on the improvements in 23/24, with the ambition to go further in the four key priority areas:
Empower patients
· Increase use of NHS App and other digital channels.
· Continue to expand self-referrals to appropriate services.
· Expand uptake of Pharmacy First.
Implement New Modern General Practice Access
· Complete implementation of better digital telephony.
· Complete implementation of highly useable and accessible online journey for patients.
· Complete implementation of faster care navigation, assessment, and response.
· National transformation/improvement support for general practice systems.
Build Capacity
· Continue with expansion and retention commitments in the long-term workforce plan.
Cut Bureaucracy
· Make further progress on implementation of the four Primary Care Secondary Care Interface Arm recommendations.
· Make online registrations available in all Practices.
3.6 The new government has also set this out as a priority in the context of its wider stated review of the NHS and the recently published Independent Investigation of the National Health Service in England which highlighted that GPs are seeing more patients than ever before, but with the number of fully qualified GPs relative to the population falling, waiting times are rising and patient satisfaction is at its lowest ever level. There are [significant] variations in the number of patients per GP, and shortages are particularly acute in deprived communities. The NHS is determined to make it easier and quicker for patients to see their GP and members of the primary care team’.
3.7 Additionally, there is a continued focus on reducing disparities in healthcare access across different regions and demographic groups. The NHS aims to ensure that all patients can access a GP appointment within two weeks, with urgent cases being assessed the same day or the next, regardless of location. This goal is part of a broader effort to eliminate unwarranted variation in care across the country.
4 Improving Access – A Priority for Sussex
4.1 The national commitments to improving access to Primary Care align well with the existing Sussex focus, as set out in the Sussex Shared Delivery Plan and agreed with our system partners.
4.2 As well as improving access, in Sussex we also want to work with patients and communities to improve understanding of how modern General Practice works, ensure we reduce any barriers and inequalities, and reduce any unwarranted variation that may exist across Sussex in how General Practice access works.
4.3 There has been positive progress in Sussex, with record numbers of appointments being delivered:
· Between April to October 2024 over 6.7 million General Practice appointments were delivered across Sussex, representing an 8.6% increase in activity for the same period of 2023. For the year 2024/25 NHS Sussex is exceeding its Operating Plan target for delivery of GP appointments by 10.5%, as outlined in table 2 below.
· In October 2024, Sussex performed better than both the England and South East averages for the number of GP appointments provided per 1,000 registered patients – with 664 for Sussex, compared to 607 for England and 602 for the South East. For appointments in October across Sussex, 36.5% were held on the same-day as booking and 70.4% were held within 2 weeks of booking – against averages in England of 37.9% and 74.9%, and in the South East of 37.4% and 73.1%.
· Activity in General Practice is now surpassing pre-pandemic levels by 15% in Sussex.
Table 2: Total number of appointments delivered in Sussex.
|
Apr-24 |
May-24 |
Jun-24 |
Jul-24 |
Aug-24 |
Sep-24 |
Oct-24 |
|
|
Sussex Plan |
821,662 |
853,237 |
799,663 |
894,207 |
793,749 |
896,815 |
1,042,032 |
|
Sussex Actuals |
927,773 |
946,197 |
880,903 |
957,766 |
865,189 |
933,915 |
1,233,204 |
|
Month % v Plan |
12.9% |
10.9% |
10.2% |
7.1% |
9.0% |
4.1% |
18.3% |
|
YTD % v Plan |
12.9% |
11.9% |
11.3% |
10.2% |
10.0% |
8.9% |
10.5% |
4.4 Our priorities across Sussex in 2024/25 are to maintain the focus on improving the experience of access to primary care, by supporting General Practice to ensure that everyone who needs an appointment with their GP practice gets one within 2 weeks and those who contact their practice urgently are assessed the same or next day according to clinical need, to reduce unwarranted variation for PCNs and practices.
5 GP Appointments in Brighton & Hove
5.1 The total number of appointments delivered in Brighton and Hove has increased over the last year.
5.2 Table 3 provides the detail of the number of appointments delivered across Brighton and Hove since April 2024. In total between April-October 2024 there have been 1,002,837 appointments in Brighton & Hove compared to 955,122 in the same period in 2023 – a 5% increase in the numbers delivered by Practices. In October 181,452 appointments were delivered across the 31 GP Practices – 10.5% more than in the same month last year.
|
Brighton & Hove |
Apr |
May |
Jun |
Jul |
Aug |
Sep |
Oct |
YTD |
|
2023-24 |
117,441 |
134,483 |
139,333 |
127,820 |
133,031 |
138,739 |
164,275 |
296,027 |
|
2024-25 |
137,933 |
139,409 |
131,516 |
143,011 |
131,091 |
138,425 |
181,452 |
313,377 |
|
2024 v 2023 |
17.4% |
3.7% |
-5.6% |
11.9% |
-1.5% |
-0.2% |
10.5% |
5.9% |
Table 3: Number of appointments delivered in Brighton and Hove
5.3 The below tables set out the benchmarking data on the three nationally reported access measures – number of appointments per 1000 population, appointments on the same day and appointments held within 2 weeks. In summary the position for October 2024 across these metrics are: 544 appointments per 1000 registered patients, with 32.9% delivered on the same day as booking, and 71.9% within 2 weeks. These measures are outlined in table 4 to 6 below:
|
Appointments Per 1000 List Size |
|||||||
|
Apr-24 |
May-24 |
Jun-24 |
Jul-24 |
Aug-24 |
Sep-24 |
Oct-24 |
|
|
Brighton & Hove |
414 |
418 |
394 |
429 |
394 |
416 |
544 |
|
West Sussex |
512 |
524 |
487 |
536 |
479 |
520 |
687 |
|
East Sussex |
536 |
545 |
504 |
537 |
489 |
528 |
693 |
|
Sussex Total |
502 |
511 |
476 |
517 |
467 |
504 |
664 |
|
South East |
473 |
474 |
444 |
483 |
430 |
467 |
602 |
|
England |
482 |
482 |
452 |
500 |
436 |
472 |
607 |
Table 4: Sussex Appointments per 1000 patients
|
Appointments on Same Day % |
|||||||
|
Apr-24 |
May-24 |
Jun-24 |
Jul-24 |
Aug-24 |
Sep-24 |
Oct-24 |
|
|
Brighton & Hove |
38.1% |
38.0% |
37.9% |
37.2% |
40.1% |
38.8% |
32.9% |
|
West Sussex |
44.1% |
43.6% |
43.7% |
44.3% |
45.1% |
44.5% |
37.0% |
|
East Sussex |
45.5% |
45.5% |
44.4% |
43.2% |
44.8% |
43.7% |
37.2% |
|
Sussex Total |
43.7% |
43.4% |
43.1% |
42.9% |
44.2% |
43.4% |
36.5% |
|
South East |
44.8% |
44.5% |
44.2% |
43.7% |
44.7% |
43.1% |
37.4% |
|
England |
44.6% |
44.3% |
44.0% |
43.9% |
44.5% |
43.2% |
37.9% |
Table 5: Sussex Appointments on Same Day %
|
Appointments Held Within 2 Weeks % |
|||||||
|
Apr-24 |
May-24 |
Jun-24 |
Jul-24 |
Aug-24 |
Sep-24 |
Oct-24 |
|
|
Brighton & Hove |
77.7% |
78.4% |
79.7% |
79.8% |
80.4% |
79.4% |
71.9% |
|
West Sussex |
79.0% |
79.4% |
79.3% |
79.2% |
80.0% |
79.4% |
69.0% |
|
East Sussex |
80.6% |
81.1% |
80.3% |
79.5% |
80.3% |
79.2% |
72.2% |
|
Sussex Total |
79.3% |
79.8% |
79.7% |
79.4% |
80.1% |
79.4% |
70.4% |
|
South East |
80.6% |
81.3% |
81.2% |
81.2% |
81.6% |
80.6% |
73.1% |
|
England |
81.8% |
82.4% |
82.4% |
82.7% |
82.5% |
81.9% |
74.9% |
Table 6: Appointments held within 2 weeks %
5.4 Between April 2024 and October 2024, practices in Brighton and Hove have recorded fewer numbers of appointments per 1000 list size than both the Sussex, Regional and National average. This patten in performing below the Regional and National averages is reflected for both the measures for appointments on the same day and the percentage of appointments seen within 2 weeks – although it should be noted that for the measure of percentage of patients seen within 2 weeks Brighton and Hove practices perform comparably with the Sussex average.
5.5 Whilst it is positive that the total number of appointments has increased over the last 12 months, we recognise that we need to go further in ensuring that we continue to review these key access metrics in order to maintain and improve access to general practices in Brighton and Hove, whilst noting that General Practices are not contractually obliged to deliver a specific number of appointments per year.
5.6 Table 7 below provides the detail of the appointments and consultation types in Brighton and Hove, highlighting the breakdown of the total number of appointments by type, e.g. face to face, video consultation/online, telephone and home visits.
 |
Table 7: Breakdown of consultation type in the last 12 months
5.7 In October, GPs provided 41.1% of the total number of consultations, other staff 54.3% with GP consultations 6.0% higher compared to the same time last year while consultations by other practice staff were up by 10.7%. This is above the Sussex position for GP consultations which were 4.6% higher compared to last year.
5.7 Annex B and C provides further detail for members on the breakdown of appointment data at Practice and PCN level for both total number of appointments, same day and those seen within 2 weeks. When reviewing this information, it’s important to acknowledge that whilst this is used nationally the Data in the General Practice Appointments Data (GPAD) collection is known to contain a number of data quality issues as practices manage their appointment books in the way they best feel allows them to manage the health and care of their patients and not for the purpose of data analysis.
6 Increasing the Primary Care Workforce
6.1 Increasing the Primary Care workforce is both a national and local priority, both in terms of recruiting and training more staff, but also supporting and retaining existing ones too. Nationally the previous government set out a Long Term Workforce Plan for the NHS in June 2023, while in Sussex we have developed our own Sussex People Plan across system partners which includes a key focus upon supporting the Primary Care workforce. This is particularly important not just for improving access to Primary Care, but also in working with partners to develop new Integrated Community Teams (ICTs) in Sussex.
6.2 Across Sussex, we have exceeded our overall recruitment targets for the Primary Care Workforce at both a PCN and practice level in the last year. Compared to a year ago the Primary Care workforce increased by 300.5 FTE (or 5.2%) to 6051 FTE. The Clinical workforce grew by 5.0% or 157.4 FTE; non-Clinical staff +5.5% or 143.1 FTE.
6.3 The total number of GPs (includes GP partners; salaried GPs; GPs in training grades; GP locums and GPs on retainer) has increased by 6.4% (+63 FTE) compared to October 2023 staff levels.
6.4 In Brighton & Hove, compared to a year ago the Primary Care workforce increased by 67.7 FTE (or 7.5%) to 971 FTE. The Clinical workforce grew by 5.0% or 25.4 FTE; non-Clinical staff +10.6% or 42.3 FTE. Table 8 below outlines this position over the last 12 months:
 |
Table 8: Brighton and Hove Primary Care workforce
6.5 Further points to note for the position in Brighton & Hove include:
· The total number of GPs (includes GP partners, salaried GPs, GPs in training grades, GP locums and GPs on retainer) has increased by 8.3% (+14 FTE) compared to October 2023 staff levels.
· The Fully Qualified GP workforce has increased by 14.7% (19.7 FTE) compared to October 2023. Since March 2019 Fully Qualified GP staff has increased by 26.3%.
· Fully Qualified GP staff in FTE/100k patients for Brighton and Hove is 46.2 which is above the Sussex level at 46.0 and above England at 44.0.
6.6 Additionally, PCNs draw on the expertise of staff already employed by their constituent practices as well as receive funding to employ additional staff under the Additional Roles Reimbursement Scheme (ARRS).
6.7 The following ARRS roles have seen an increase across Brighton and Hove over the last year in comparison to October 2023 WTE numbers:
· Adult Mental Health Practitioner (67.41%)
· Advanced Practitioner Role (75.28%)
· Care Coordinator (33.57%)
· First Contact Physiotherapist (13.64%)
· Trainee nursing associate (180.00%)
· Digital and Transformation Lead (111.11%)
6.8 One of the first acts of the new Government has been to amend the national Direct Enhanced Service (DES) scheme to allow PCNs to now also include the ability to recruit newly qualified GPs through it, and we are working currently to support all PCNs, including in Brighton & Hove, to take up this offer. In October 1.00 WTE GP have been recruited under the scheme to date.
7 Improving access and reducing unwarranted variation in Primary Care
7.1 Improving access and reducing unwarranted variation in primary care in Sussex continues to be a key priority and is fundamental in ensuring the long term, successful delivery of high-quality and equitable Primary Care services to our population, giving people better and quicker access to the right services when they need them and to reduce unwarranted variation in the delivery and outcomes of those services.
7.2 There are a number of benefits of reducing variation in primary care:
· Improved patient outcomes
· Enhanced equity in healthcare
· Increased efficiencies
· Improved patient experience
· Greater accountability and measurement
· Fostering innovation and best practice
· Better chronic disease management
· Improved public health outcomes and reduce inequalities
7.3 To fully understand the impact of variability and variation in primary care services across Sussex, it is important to consider wider contributing factors. In the context of general practice, this relates to differences in appointment availability, waiting times, and the overall net effect this has on patient experience.
7.3 To understand and address the impact of variation in General Practice and improve patient experience and clinical outcomes, the NHS Sussex Primary Care Team have been working alongside the GP Clinical Directors to co-design a quality and service improvement project to be delivered in 2025.
7.4 Four priority areas with associated metrics have been identified to support the programme of work; these include:
· Improving Patient Access to General Practice
· Disease Management
· Patient Experience
· Referral Pathways and Interface
7.5 The aim of this programme is to provide a supportive framework for general practices to review and analyse their practice level data to identify areas of concern, share best practice, and develop their own practice and PCN level interventions to address identified areas of improvement.
7.6 This scheme is focussed on metrics that allow practices to better understand where unwarranted variation exists providing support to identify where improvements can be made, based on sharing best practice and utilising quality improvement methodologies to enable change to happen at an individual practice and system level change.
7.7 All practices in Brighton and Hove will have the opportunity to participate in the new quality improvement programme beginning in early 2025 aiming to achieve the following outcomes:
· Practices gain an understanding their own data from the data packs focussing on practice, PCN and ICT level outcomes, and what that means for each area to improve patient outcomes – achieved by engaging practice staff and communicating the challenges and opportunities back into practice.
· Practices establishing improved leadership and collaboration for clinical improvement, including referrals and pathways within each practice and ICT.
· Individual practice improvement plans drawn up, implemented and monitored by the practices to ensure improvements are demonstrated and the baseline position improves.
· Practices promoting good practice and clinical governance within the practice, and across local PCN and ICT footprints.
8 Improving Access through delivering Enhanced Access
8.3 The Enhanced Access delivers approximately an additional 330 hours of appointments per week across Brighton and Hove beyond core hours, which includes the following:
· a mixture of face-to-face and remote (telephone, video or online) appointments.
· appointments delivered by a multi-disciplinary team of healthcare professionals, including GPs, nurses and other “additional roles” such as mental health practitioners, physician associates, physiotherapists, and Social Prescribers.
· a blend of appointments offered on the same day or pre-booked for a future day.
8.4 These flexibilities enable patients to offer targeted interventions in addition to regular appointments, such as specific screening clinics, support for patients’ groups as well as support for the system in times of surge demand, for example over winter.
9 Improving access by improving models of General Practice
9.1 Across Brighton and Hove Practices have been focussing upon improving their access models for patients to reflect better technology and trying to make it easier for patients to navigate how General Practice works to get the support they need.
9.2 Part of this has involved implementation of the ‘Modern General Practice Access’ model, which comprises a move to increase the role of triage, digital telephony, making online requests simpler, and offering faster navigation, assessment, and responses for patients. This model sits within a wider context of efforts to improve access for patients through innovations such as the NHS App, Online Consultations and improving Practice websites.
9.3 One of the advantages of moving to this model is that Practices will be better able to see and understand the needs and demand of their patients, as well as the current capacity to manage this. By streamlining how patients can receive advice, prescriptions and other support which may not need an appointment, Practices are then able to use their full multi-professional team to ensure patients receive they need.
9.4 Each patient is unique and, given the diversity of Practices and Communities in Brighton and Hove, how each model of access works needs to be tailored to the needs of that local population. As part of the move to promote ‘Modern General Practice Access’ models, NHS Sussex has received and used national funding available to support GP Practices, including:
· Staff training for care navigation, including Pharmacy First.
· Protected learning time for wider Practice teams to explore and work on new protocols and processes, updating appointment templates, auditing templates, reviewing booking messages, staff planning and contingency planning.
· Increasing online consultation capacity in a sustainable way.
9.5 We have also worked with the Brighton and Hove PCNs to implement “Capacity & Access Improvement Plans” linked to the GP Contract in 2023/24 – specifically agreeing with each of them a set of deliverable improvements linked to 1) Patient experience of contact, 2) Ease of access and demand management, and 3) Accuracy of recording in appointment books. Below outlines examples of some of the improvements achieved in 23/24:
· North & Central PCN – practice websites have been standardised and unified across the PCN to that data comparison can be undertaken and patients have the same access
· Deans & Central PCN – increase recruitment into the ARRS roles to increase access to services and improved patient satisfaction
· West Hove PCN – ran community blood pressure events ‘Well in the West’
· Preston Park Community PCN – PCN digital ambassador worked with housebound/frail patients to increase the use of the NHS App as well as provided a digital drop-in in one surgery.
· Goldston PCN – introduced group consultations to suport long term conditions, and increased capacity for HRT appointments following both patient and GP feedback
9.6 NHS Sussex have recruited three peer ambassadors who all draw on their own experiences of implementing change within primary care to share their learning and help other practices to move to a modern general practice access model. There are three roles with primary care representation from Brighton & Hove, East Sussex and West Sussex and support is available to all NHS practices within Sussex. The peer ambassadors are working with NHS Sussex to encourage and support practices to adopt this new approach to delivering care.
9.7 In Brighton and Hove the peer ambassador is currently working closely with practices and PCNs to develop a group application for Transition Fund monies to improve care navigation pathways and provide training for staff. There are a small number of practices in Brighton and Hove who have not yet submitted a bid to access this funding. In response the peer ambassador for Brighton and Hove, is currently supporting these practices to develop bids, working with them to take full advantage of the available national funding.
9.8 The following summarises the common themes and those programmes for improving access that were implemented in Brighton & Hove as a result:
|
|
Common Themes for Improving Access |
|
Patient Experience of Contact |
· Promote the use of online consultations and NHS App · Updating and improving practice websites to improve functionality and help patients access information and online tools such as eConsult’s · Development of Patient Participating Groups (PPGs) · Improve on Friends and Family Test usage · Care navigation training for reception staff to improve signposting and reduce inappropriate appointments. · Launch use of cloud-based telephony |
|
Ease of access and demand management |
· Setting up of ‘Access hubs’ for managing appointment requests. Multi-disciplinary team working models which are clinically led to triage patient contacts, directing patients to see the most appropriate healthcare professional first time. · Improve the practice call back offering. · Continues use of e-hub · Engage with Training Programmes |
|
Promoting the use of digital tools |
· Using digital tools to effectively manage patient requests treating all requests equitably regardless of how the request is generated i.e. on-line, by phone, in person. · Using digital tools to understand and map patient demand and capacity to better manage staff and resources. · Increase the use of automation with existing software and clinical systems to streamline processes i.e. repeat prescriptions. · Information and education sessions for patients to raise awareness & support greater use of tools such as the NHS App and online consultation products. |
|
Staff training and skills development |
· Training staff in the use of on-line consultations and the NHS App to enable them to promote these services to patients. · Upskilling additional healthcare professionals to free up GP and ANP time and enable more clinical appointments to be offered. · Training for practice staff on the Pharmacy First scheme, including criteria for referrals and using the referral software |
|
Accuracy of recording in appointment books |
· Utilise APEX data tool · Review APEX data tool · Provide training on more effective use of clinical systems and available data · New processes to support accurate recording of appointments. · General Practice Appointment Dashboard (GPAD) appointment data cleansing and accuracy exercise |
10 The General Practice Improvement Programme
10.1 Across Sussex, 16 Practices are participating in the National General Practice Improvement Programme (GPIP) Practice Level Support offer (PLS). The PLS focuses on helping practices move towards a modern general practice model by supporting change in three improvement areas:
· improving patient experience of access (online and via phone),
· supporting practices to improve care navigation and clinical triage workflow to safely and
· effectively assess patient needs (supported by online consultation tools)
· better aligning existing capacity with demand including optimising use of a multidisciplinary team across the practice and PCN
10.2 National statistics show that Practices moving to Modern General Practice have improved patient experience, staff satisfaction and continuity of care, and have tailored care according to need and put in place a more responsive service for patients. Practices participating in the GPIP Practice Level Support on average can achieve:
· Improvements in access*:
· 15% to 61% increase in online consultation use (digital access)
· 9% to 50% reduction in call wait times
· 13% to 52% reduction in abandoned calls
*Based on a sub-analysis from 332 sites receiving 6 months support
· Improvements in aligning existing capacity to demand:
· Average 5.1% reduction in avoidable appointments
· Average 9 hours 17m / week released in clinical time
· Average 9 hours 19m / week released in admin time
10.3 Time released enables staff to use this time for more role appropriate work, spend more time with patients, provide more appointments, answer phones, supervise staff and support wellbeing.
10.4 In Brighton & Hove, 7 Practices are participating in the GPIP programme – these are Links Road Surgery, The Avenue Surgery, Wish Park Surgery, Carden Surgery, Brighton Station Health Centre, Park Crescent Health Centre and Preston Park Surgery. All are progressing as expected, focussing on a variety of data driven areas to improve access. These include making processes more efficient in reception, reviewing online consultation usage, appointment schedules, capacity and demand data and staffing and recruitment, and ensuring that for each booked appointment, the most appropriate clinician is assigned to the patient’s needs which results in an increase in pre-bookable appointments.
10.5 Successes to date include:
· New admin time created for reception staff, resulting in cleared backlogs.
· Greater control of online consultation processes resulting in appointments being allocated more appropriately.
· 100 minutes per week of clinical appointments were freed up in just one Practice.
· Reception can now book into appointments that remain unused by 3pm.
· Changed processes to allow all nurse and blood appointments to be cancelled via text, freeing them up for other patients to be booked into.
· Online systems for triage and new appointments are reported to be working really well.
· Greater sight of actual capacity and demand with measurements. Data gathering and analysis showed which access improvement areas would make the most difference.
11 Our forward plan for improving access in Brighton & Hove
11.1 Our focus in 2024/25 is to ensure that everyone who needs an appointment with their GP practice gets one within 2 weeks, and those who contact their practice urgently are assessed the same or next day according to clinical need. This includes a continued focus on reduce unwarranted variation across our PCNs and Practices, through the implementation of a quality improvement programme in 2025.
11.2 We recognise the need to go further and maintain improvements through a combination of the improvement measures and programmes outlined in the paper, as well as proactively engaging with our local practices, PCNs and neighbourhood teams to better understand the evidence base and opportunities to develop innovative and sustainable improvements to ensure that the model of general practice in Brighton and Hove reflects the needs of the local population.
12 Conclusion
12.1 This report gives an overview of the latest position for the Brighton and Hove HOSC on improving access to General Practice services locally.
12.2 Improving access to, and outcomes and experience of Primary Care, is a continuing strategic priority for NHS Sussex. We are committed to maintaining our focus on making it easier for patients to access community and primary care services in Brighton and Hove, particularly General Practice.
12.3 NHS Sussex is committed to ensuring that everyone across our communities have access to high quality health and care services when they need support.