Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the additional treatments and facilities that could be provided in general practice facilities so that patients do not have to attend out-patient hospitals.

The NHS Long Term Plan, published in January 2019, committed to an unprecedented investment in primary medical and community services so that £4.5 billion more will be spent in these areas in real terms by 2023/24. As part of this a new five-year general practitioner (GP) contract framework was also signed in January 2019.

The new system of Primary Care Networks (PCNs) launched in 2019 have been designed to ensure care happens in the optimal place for patients. The contract provides them with funding for 20,000 new staff who will help mitigate current workload pressures in primary care as well as supporting delivery of seven new services (five of which will begin during 2020) focussed on areas where there is evidence that primary care activity can improve patient outcomes. These implement different aspects of the Long Term Plan: medication reviews; the care homes service; the anticipatory care service; the National Health Service comprehensive model of personalised care; early cancer diagnosis; cardiovascular disease prevention and diagnosis; and health inequalities. Pilots of the enhanced health in care homes service - which will be delivered by all PCNs - have demonstrated the potential to reduce the number of care home residents requiring an emergency hospital admission.

Investment in primary and community services will support the Long Term Plan’s ambition of transforming out-of-hospital care to a model that is fit for the 21st Century, including avoidance of 30 million hospital appointments which will result in an annual saving of over £1 billion.

PCNs will be able to access an ‘investment and impact fund’ from 2020, which will be worth £75 million, building up to £300 million by 2024. The purpose of the Fund is to help PCNs plan and achieve better performance against metrics in a new network dashboard. As well as incentivising better performance in the new service areas, part of the Fund will be dedicated to the commitment made in the NHS Long Term Plan to making ‘shared savings’. This savings scheme will be tied to the development of community-based services that enable reductions in hospital activity, such as avoidable out-patient visits as part of outpatient redesign, as well as avoidable accident and emergency attendances; avoidable emergency admissions; timely hospital discharge; and prescribing costs.