A presentation from the GP Forward View update event in May 2017 for Midlands and East, giving the latest information on what the Forward View is delivering.

1. Stabilising and transforming services for the future
General Practice Forward View In Action
STP Events
Midlands and East
• Building on the GPFV engagement events carried out by the national NHS
England team during 2016 and March this year
• Hosted by NHS England regional office in partnership with RCGP, and Health
Education England
• 11 events across the Midlands and East reaching over 500 general practitioners,
practice managers and teams, and primary care managers

2. Stabilising and transforming services for the future
Staffordshire – 2 February
Shropshire, Telford and Wrekin – 28 February and 6 April
Birmingham and Solihull – 1 March
Lincolnshire – 21 March
Cambridge and Peterborough – 22 March
Derbyshire – 29 March
Nottinghamshire – 30 March
Leicestershire and Rutland – 6 April
The Black Country – 6 April
Norfolk and Waveney – 20 April
Regional GPFV STP Events

3. Stabilising and transforming services for the future
Regional GPFV STP Events
Purpose:
• raising awareness of GPFV and promoting opportunities and benefits for
general practice, patients and populations
• informing local primary care communities of next steps and what it
means for general practice (including STP, local general practice and
primary care plans)
• discussing challenges and developing sustainable solutions locally;
• focusing on general practice skill mix to optimise benefits, including
information on the Clinical Pharmacy Phase 2 Transformation
Programme
• sharing good practice across the STP footprint area

4. Stabilising and transforming services for the future
Learning and feedback
• Good start in establishing positive engagement and dialogue
– clearly much more to be done
FAQs from the events so far:
• How to put the 10 high impact changes in to practice
• How to access funding for GPFV initiatives in a timely way
• How CCGs will share learning across local populations and
use their commissioning powers to incentivise change and
change behaviours (both professionals and patients)

5. Stabilising and transforming services for the future
We’re fighting fires –
can transformation
funds be used to close
for a day and provide
much needed thinking
time?
What is being
done to support
small practices?
I’m now convinced that
practice at scale is needed
but unconvinced that
there is enough desire
within my area to really
drive it within the
timescale
Lack of definitions for
new roles – AHPs,
ANPs, PA’s etc –
brings challenges for
indemnity insurance
What can be done
to educate the
public and
manage
expectations?
Is accessing
funding
dependent on
seven day
access?
Working through sustainable solutions together
to some of the hot topics

6. Stabilising and transforming services for the future
Some of the positives
• “The ‘developing your workforce’ session was fantastic –
hearing from real life PCNs, ANPs, Clinical Pharmacist’s, PAs
and even an Advanced specialist mental health nurse
practitioner! I will discuss new roles and models of working
with the partners”
• “Useful contacts made and a consistent message delivered
across the West Midlands”
• “It’s clear delivery of primary care at scale is the right
direction”
• “Much better understanding of the issues facing GPs and
their practice teams”

7. Stabilising and transforming services for the future
Some of the ‘not so’ positives
• “Frustrated that I still don’t have a clearer idea on how the
money will reach practices”
• “I wanted to know how CCGs will work with GPs, patients and
the public and I am still no wiser”
• “Like with Five Year Forward View we are trying to do too
much too quickly and leaving smaller practices behind”
• “Developing your workforce sessions were great but I don’t
know how to access information and funding”
• “We are sold on the ‘why and what rhetoric’ please now
provide the ‘how’!”

8. Stabilising and transforming services for the future
What are GPs and their teams looking
for from you?
• Ongoing engagement and dedicated time for horizon
scanning and action planning / more locality meetings and
protected time
• Clear and timely communication about priorities and how to
access funding for new initiatives
• Learning and evidence of success and what works
• Point of contact for ongoing advice and support

9. Stabilising and transforming services for the future
Midlands and East GPFV
Committed to continued engagement
• Further workforce events across the region
• Stakeholder engagement event with LMC colleagues 12th
July
• Please regularly visit the new NHS England General Practice
web pages GPFV https://www.england.nhs.uk/gp/
• Join the conversation on Twitter: #GPforwardview

10. Stabilising and transforming services for the future
General Practice Forward View
Midlands and East Update Event
Malcolm Pearce
GPFV Regional Lead

11. Stabilising and transforming services for the future
Context
The context of implementing the GPFV stems from the 5YFV. Three gaps identified
to be addressed:
1. Health and well-being gap – requiring a radical upgrade in prevention, empowering
patients and engaging communities
2. Care and quality gap – to be addressed through new models of care, to deliver more
care out-of-hospital by integrating services around the patient
3. Funding gap – driving need for greater efficiency from existing NHS funds through
targeted investment to better manage demand through greater prevention. Driving
greater efficiency from current care system, by exploiting information revolution,
aligning NHS systems and developing a modern workforce.
The GPFV is a critical component and essential building block for the future of the NHS.
Delivering strengthened (more resilient, bigger and integrated) primary and community
services at the heart of the new NHS Operating model

12. Stabilising and transforming services for the future
General Practice Forward View
– our essential outcomes
AT SCALE PRIMARY CARE
PROVISION
I
N
V
E
S
T
M
E
N
T
W
O
R
K
F
O
R
C
E
E
X
T
E
N
D
E
D
&
E
N
H
A
N
C
E
D
A
C
C
E
S
S
SUSTAINABLE AND RESILIENT GENERAL
PRACTICE

13. Stabilising and transforming services for the future
Midlands and East GPFV
Governance Structure

14. Stabilising and transforming services for the future
NECS Team Structure
Mobile DCO Teams
Line Managed by PMO
DCO Teams – Line Managed within DCO
ANDREW PIKE
Director of Commissioning Ops - East
Regional PMO Team
MALCOLM PEARCE
Regional PMO Lead
James Wilks
Programme Manager
Paulina Iwanicka Interim
Admin Support
Chiara Bo
Data Analyst
DCO Team
SUE HART
DCO Team Lead
Ranjini Mathew
Senior Consultant
Angela Hopper
Programme Manager
Sarah Rutter
Senior Consultant
ALLY ROBSON NECS
Account Lead
Heather Thornton
Senior Consultant
DAVID LEVY
Medical Director
RACHEL HELMN
Workforce Lead
SUE HART
DCO Team Lead / Access
Daniel Neville
Business Analyst
Simon Parkes
Coordinator
Coordinator
Phil Morgan
Project Manager
Simon Aldridge
Senior Consultant
Programme Manager
*Interim
Fiona Baldwin
Senior Consultant
Danette Carter
Programme Manager
Stacey Egan
Senior Consultant
Laura MacPherson
Consultant
*Phil Stimpson
Senior Consultant
East DCO Central Midlands DCO North Midlands DCO West Midlands DCO
In Post
To Start
Vacant
Regional PMO Team
MALCOLM PEARCE
Regional PMO Lead

15. Stabilising and transforming services for the future
Stage 1 & 2 Reviews
• Broadly narrative descriptions of GPFV plans
• Short timeline to produce and reviewed by 1 independent reviewer (PMO)
• Mixture of CCG/STP submissions
• RAG ratings provided
• Detailed planning guidance developed and issued to CCGs/STPs for stage 2
• Higher level of detail required with delivery plans/finances
• Encouraged to submit on a STP footprint
• 4 weeks to produce, 2 weeks to review by 2 independent reviewers from PMO
• DCOs also given option to review
• RAG ratings and outcomes for each agreed by regional team - 20th March feedback provided to
CCGs/STPs
• Robert Varnum GPFV Event/Workshop planned (postponed to 17th May)

16. Stabilising and transforming services for the future
National Assurance – West Midlands
Improving access
Care redesign &
development
Investment in Primary
Care Workforce
Practice
infrastructure
Overall
Assurance
DCO Name of STP Name of CCG
GP extended access
to 100% of the CCG
population
a. Support to
Practice
receptionists
and clerical
staff
b. Roll-out of
online
consultation
systems
across
general
practice
(between
17/18 – 19/20)
a. Overall
commitment
to increase
investment
b. Practice
Transformatio
n Fund -
Planned
commitment
to invest non-
recurrently £3
per head of
CCG
population
Workforce
strategy &
expanded
primary care
workforce
Estates and
Digital road
maps
DCO
assessment
West
Midlands
Birmingham and Solihull
NHS SOLIHULL CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS BIRMINGHAM CROSSCITY CCG
NHS BIRMINGHAM SOUTH AND
CENTRAL CCG
Black Country and West
Birmingham
NHS DUDLEY CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SANDWELL AND WEST
BIRMINGHAM CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WALSALL CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WOLVERHAMPTON CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Coventry and Warwickshire
NHS COVENTRY AND RUGBY CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SOUTH WARWICKSHIRE CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WARWICKSHIRE NORTH CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Herefordshire and
Worcestershire
NHS HEREFORDSHIRE CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WYRE FOREST CCG Assured
Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS SOUTH WORCESTERSHIRE CCG Assured
NHS REDDITCH AND BROMSGROVE
CCG Assured

17. Stabilising and transforming services for the futureNHS Official Sensitive:
National Assurance – East Midlands
Improving
access
Care redesign &
development Investment in Primary Care Workforce
Practice
infrastructure
Overall
Assurance
DCO Name of STP Name of CCG
GP extended
access to
100% of the
CCG
population
a. Support to
Practice
receptionists
and clerical
staff
b. Roll-out of
online
consultation
systems
across
general
practice
(between
17/18 – 19/20)
a. Overall
commitment to
increase
investment
b. Practice
Transformation
Fund - Planned
commitment to
invest non-
recurrently £3
per head of CCG
population
Workforce
strategy &
expanded
primary care
workforce
Estates and
Digital road
maps
DCO
assessment
East Midlands
Cambridgeshire and
Peterborough
NHS CAMBRIDGESHIRE AND
PETERBOROUGH CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Mid and South Essex
NHS BASILDON AND BRENTWOOD CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured Assured
Partially
Assured
NHS CASTLE POINT AND ROCHFORD CCG
Assured Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS MID ESSEX CCG
Assured Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SOUTHEND CCG
Assured Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS THURROCK CCG
Assured Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Norfolk
NHS GREAT YARMOUTH AND WAVENEY
CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS NORWICH CCG
Assured Assured
Partially
Assured
Partially
Assured Assured
Partially
Assured
Partially
Assured
Partially
Assured
NHS WEST NORFOLK CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured
Partially
Assured
Partially
Assured
NHS NORTH NORFOLK CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SOUTH NORFOLK CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Suffolk and North East
Essex
NHS NORTH EAST ESSEX CCG
Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WEST SUFFOLK CCG
NHS IPSWICH AND EAST SUFFOLK CCG

18. Stabilising and transforming services for the future
National Assurance – North Midlands
Improving
access
Care redesign &
development
Investment in Primary
Care Workforce
Practice
infrastruct
ure
Overall
Assuran
ce
DCO Name of STP Name of CCG
GP extended
access to
100% of the
CCG
population
a. Support to
Practice
receptionists
and clerical
staff
b. Roll-out of
online
consultation
systems
across general
practice
(between 17/18
– 19/20)
a. Overall
commitment to
increase
investment
b. Practice
Transformation
Fund - Planned
commitment to
invest non-
recurrently £3 per
head of CCG
population
Workforce
strategy &
expanded
primary care
workforce
Estates and
Digital road
maps
DCO
assessment
North
Midlands
Derbyshire
NHS EREWASH CCG Assured
Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS HARDWICK CCG Assured
NHS NORTH DERBYSHIRE CCG Assured
NHS SOUTHERN DERBYSHIRE CCG Assured
Nottinghamshire
NHS MANSFIELD AND ASHFIELD CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Partially
Assured
Partially
AssuredNHS NEWARK & SHERWOOD CCG
NHS NOTTINGHAM CITY CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS NOTTINGHAM NORTH AND EAST CCG
NHS NOTTINGHAM WEST CCG
NHS RUSHCLIFFE CCG
Shropshire and
Telford and Wrekin
NHS SHROPSHIRE CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
AssuredNHS TELFORD AND WREKIN CCG
Staffordshire
NHS EAST STAFFORDSHIRE CCG Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS CANNOCK CHASE CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS SOUTH EAST STAFFORDSHIRE AND
SEISDON PENINSULA CCG
NHS STAFFORD AND SURROUNDS CCG
NHS NORTH STAFFORDSHIRE CCG
Assured Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
AssuredNHS STOKE ON TRENT CCG

19. Stabilising and transforming services for the future
National Assurance – Central Midlands
Improving
access
Care redesign &
development
Investment in Primary
Care
Workforc
e
Practice
infrastruc
ture
Overall
Assuran
ce
DCO Name of STP Name of CCG
GP extended
access to
100% of the
CCG
population
a. Support to
Practice
receptionists
and clerical
staff
b. Roll-out of
online
consultation
systems
across general
practice
(between 17/18
– 19/20)
a. Overall
commitment to
increase
investment
b. Practice
Transformation
Fund - Planned
commitment to
invest non-
recurrently £3
per head of CCG
population
Workforce
strategy &
expanded
primary care
workforce
Estates and
Digital road
maps
DCO
assessment
Central
Midlands
Hertfordshire and West
Essex
NHS EAST AND NORTH
HERTFORDSHIRE CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS HERTS VALLEYS CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WEST ESSEX CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS WEST ESSEX CCG Assured
Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Leicester,
Leicestershire and
Rutland
NHS EAST LEICESTERSHIRE AND
RUTLAND CCG Assured
Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
AssuredNHS LEICESTER CITY CCG Assured
NHS WEST LEICESTERSHIRE CCG Assured
Lincolnshire
NHS LINCOLNSHIRE EAST CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS LINCOLNSHIRE WEST CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SOUTH LINCOLNSHIRE CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS SOUTH WEST LINCOLNSHIRE
CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Milton Keynes,
Bedfordshire and Luton
NHS BEDFORDSHIRE CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
NHS LUTON CCG Assured Assured
Partially
Assured Partially Assured Assured
Partially
Assured Assured
Partially
Assured
NHS MILTON KEYNES CCG Assured Assured
Partially
Assured Assured Assured
Partially
Assured Assured
Partially
Assured
Northamptonshire
NHS CORBY CCG Assured Partially
Assured
Partially
Assured
Assured Assured
Partially
Assured
Assured
Partially
Assured
NHS NENE CCG Assured

20. Stabilising and transforming services for the future
Midlands and East:
GPFV Feedback - GP Access
Sue Hart
GPFV Regional Access Lead
17 May 2017

21. Stabilising and transforming services for the future
• NHSE commitment to delivering extended
GP access at evenings and weekends to
20% of the population by March 2017, 50%
by March 2018 and 100% by March 2019
• This commitment was expected to be met in
March 2017 through the GPAF sites and
developments in transformation areas
Background

22. Stabilising and transforming services for the future
Additional Investment
So Far
• GPAF 7.4m (14 sites)
• Transformation Fund 1.7m (6 areas)
• GPAF underspend (winter monies)
7.4m
• In 2017/18 CCGs with GPAF plus
additional geographies receive
recurrent funding of £6 per head of
pop. (weighted)
• 18/19, remaining CCGs, receive
£3.34
• 2019/20 all CCGs will receive at
least £6 per head extra recurrently
By 2018/19 Investment by
DCO
£
Central Midlands 21.9m
East 25.5m
North 25.4m
West 32.8m

23. Stabilising and transforming services for the future
Regional Performance

24. Stabilising and transforming services for the future
Full Provision Levels
Survey Results vs Plans
Trajectories
Comparison of the access survey
results for full extended access
provision with the plans
trajectories by DCO
Survey data Plans
% TOTAL PRACTICES
Oct-16 Mar-17 Sep-17 Mar-18 Sep-18 Mar-19
NHS England North Midlands 6.8% 6.4% 58% 65% 90% 100%
NHS England West Midlands 12.1% 14.5% 67% 69% 77% 100%
NHS England Central Midlands 11.7% 10.1% 51% 57% 69% 100%
NHS England East 16.5% 20.2% 49% 56% 77% 100%
13.7% v 20%
Full Access ??

25. Stabilising and transforming services for the future
Comparison With Other Regions
NHS ENGLAND
REGION
FULL PROVISION PARTIAL PROVISION NO PROVISION
% SUBMITTED
PATIENTS
% SUBMITTED
PATIENTS
% SUBMITTED
PATIENTS
London 49.3% 48.3% 2.4%
Midlands and East of
England
13.7% 70.3% 16.0%
North of England 25.1% 63.2% 11.6%
South of England 14.9% 76.8% 8.3%
BUT - 16% no provision = 2.6 million patients

26. Stabilising and transforming services for the future

27. Stabilising and transforming services for the future

28. Stabilising and transforming services for the future
Region CCG GPFV Plans - Access
28
% of GP practices by DCO which meet the definition of offering extended access
40%
50%
60%
70%
80%
90%
100%
17/18 H1 17/18 H2 18/19 H1 18/19 H2
CM E NM WM
All Projections lead
to 100% coverage by
2019

29. Stabilising and transforming services for the future
Who’s delivering 100% in 2017/18
2017-18 M1- 6
NHS Sandwell and West NHS
NHS South Worcestershire CCG
NHS Stafford and Surrounds CCG
NHS Hardwick CCG
NHS Rushcliffe CCG
NHS Erewash CCG
NHS Herefordshire CCG
NHS Leicester City CCG
NHS Thurrock CCG
NHS Birmingham CCG
NHS Dudley CCG
NHS West Essex CCG
NHS Nottingham City CCG
NHS Corby CCG
2017-18 M7- 12
NHS Ipswich and East Suffolk CCG
NHS Mansfield and Ashfield CCG
NHS Newark and Sherwood CCG
NHS Wolverhampton CCG

30. Stabilising and transforming services for the future
Programme
Support

31. Stabilising and transforming services for the future
GP Access
Governance Structure
Improving Access to
General Practice Delivery
Group (National)
ETTF (+ Digital)
Sub-Group
Resilience & SVP
Sub-Group
Workforce & MDT
Sub-Group
M&E GPFV Sub-
Group
DCO Exec Teams
GP Access Sub-
Group
Access Sub Group oversees
delivery of Midlands and East
GP targets and reports
progress to the National
General Practice Access
Delivery Group and Midlands
and East Regional GPFV Sub-
Group.
Brings together four DCO Access
Leads to support and ensure delivery
of the extended access commitment
- focus on being clear on local actions
and progress, resolving risks and
issues and sharing best practice and
knowledge

32. Stabilising and transforming services for the future
Our Approach
The PMO plan is to identify CCG/STPs where specific risk
factors are displayed including, but not limited to:
• CCGs/STPs with Stage 1 and Stage 2 plan submissions that
were assessed as sub optimal
• CCGs with a higher risk of non-delivery
• Just in time/late delivery
• 100% delivery during 2017
• CCG/STP areas showing mid week surgery closures

33. Stabilising and transforming services for the future
Next Steps
• Work with DCO teams and 17 CCGs scheduled to deliver extended
access by the end of 2017/18
• Work with 4 CCGs who received additional GP AF in 2017/18 who
are scheduled to deliver extended access by September 2017
• Targeted meetings to agree action/remedial plans where needed.
(webinars, diagnostic team input and workshops)
• Effective “audit “ processes to confirm that plans and delivery of
both robust and in line with published statements
• Circulate March 17 Access Data through to DCOs/CCGs
• Contingency plan

34. Stabilising and transforming services for the future
Risks to Delivery
• Accuracy of current access statistics
• Inability to gauge true CCG/STP ability to deliver targets
• Large number of CCGs who state they will deliver extended
services in the final six months of the programme
• Need to deliver against all 7 core requirements
• Assurance needed that CCGs/ practices are managing the in
hours service effectively
• Influence on Access targets by other related workstreams
such as workforce programme

35. Stabilising and transforming services for the future
Appendix - Information Slides

36. Stabilising and transforming services for the future
GPFV 7 Core Requirements
Timing of appointments:
• Commission weekday provision of access to pre-bookable and same day appointments to general practice
services in evenings (after 6:30pm) – to provide an additional 1.5 hours a day;
• Commission weekend provision of access to pre-bookable and same day appointments on both Saturdays
and Sundays to meet local population needs;
• Provide robust evidence, based on utilisation rates, for the proposed disposition of services throughout the
week;
• Appointments can be provided on a hub basis with practices working at scale.
Capacity:
• Commission a minimum additional 30 minutes consultation capacity per 1000 population, rising to 45
minutes per 1000 population.
Measurement:
• Ensure usage of a nationally commissioned new tool to automatically measure appointment activity by all
participating practices, both in-hours and in extended hours

37. Stabilising and transforming services for the future
Advertising and ease of access:
• Ensure services are advertised to patients, including notification on practice websites, notices in
local urgent care services and publicity that into the community, so that it is clear to patients how they can
access these appointments and associated service;
• All practice receptionists able to direct patients to the service and offer appointments to extended hours
service on the same basis as appointments to non-extended hours services
• Patients should be offered a choice of evening or weekend appointments on an equal footing to core hours
appointments.
Digital:
• Use of digital approaches to support new models of care in general practice.
Inequalities:
• Issues of inequalities in patients’ experience of accessing general practice identified by local evidence and
actions to resolve in place.
Leadership & Governance
• Ensure leadership and governance arrangements in place
GPFV 7 Core Requirements

38. Stabilising and transforming services for the future
GPFV Workforce Transformation
and New Models of Care
Mark Sanderson
Deputy Regional Medical Director
NHS England - Midlands and East
Rachel Helmn
GPFV Regional Workforce Lead
17th May 2017

39. Stabilising and transforming services for the future
Background

40. Stabilising and transforming services for the future
Workforce Challenge
• Biggest workstream within GPFV
• Aims to increase GP and other healthcare professional
numbers
• Aims to introduce new roles
• Needs to link to workload and access
• Needs to link to transformation of primary care new
models of care
• How do we stop more GPs from leaving?
• How do we know we are doing well?

41. Stabilising and transforming services for the future
The Numbers
• 5,000 extra doctors working in primary care
• 3,000 practice-based Mental Health Therapists
• 1,000 new Physician Associates
• 1,500 Practice Clinical Pharmacists
GPFV will also see additional funding to ensure the
development of practice manager support and a general
practice nurse strategy additional funding to ensure the
development of practice manager support and a general practice
nurse strategy;

42. Stabilising and transforming services for the future
What does this mean for M&E?
• North England 2020 modelling indicates Midlands and East
target is 1,600 GPs and 1,600 other clinicians
• Currently, Midlands and East have a gap of an additional
410 FTE’s that need to be met through additional
workforce schemes

43. Stabilising and transforming services for the future
Expected demand and supply
A Green rating highlights there is no additional workforce supply required against the Midlands and East target. An Amber rating
highlights a gap in workforce supply of 0-5 and a Red rating highlights a gap of more than 5.

44. Stabilising and transforming services for the future
Other clinicians numbers

45. Stabilising and transforming services for the future
RAG rating for CCG/STP GPFV plans and
the workforce supply gap combined
45

46. Stabilising and transforming services for the future
National Assurance - Definitions
and Regional Position
Table 2: % of CCGs fully assured for each domain/DCO in Midlands & East Region
Table 1: Example assurance
definition for Workforce
46

47. Stabilising and transforming services for the future
Reality
Workforce
Plans
Innovation
uptake

48. Stabilising and transforming services for the future
Transformation and
models of care

49. Stabilising and transforming services for the future
Key Questions
“What should primary care look like?”
“ What models of care are we going to embed?”
“ What workforce do we need and how many to
deliver?”
“ Where is our workforce supply coming from?”
“ How do we recruit, retain and enable return?”

50. Stabilising and transforming services for the future
Drivers behind workforce
Local transformation
through developing
whole system
models of care
Impact that new
models of care will
bring to workload,
access and workforce
Imperative for
Workforce plans to
be based on models
of care
Having the right
governance, decision
making and
management of
provider system

51. Stabilising and transforming services for the future
Enablers

52. Stabilising and transforming services for the future
GPFV Regional Workforce Team
• Focus on greater partnership between NHSE and HEE to deliver
workforce
• One regional workforce partnership plan with clear support for
delivering GPFV
• Standard approach to workforce modelling and use of tools
• Assurance of workforce plans and targets
• Influencing the national directives on key workforce programmes
• Implementing a series of workshop modules to support DCOs and
STPs

53. Stabilising and transforming services for the future
GPFV Subject Matter Experts
• Workforce Lead in each DCO providing expertise to STPs
• Provision of support in shaping new models of care, workforce
planning and accessing GPFV funds
• Linking into local based forums for workforce planning
(LWABs)
• Helping to mitigate issues and risks
• Reporting progress back to regional workforce team

54. Stabilising and transforming services for the future
Key GPFV Initiatives
International Recruitment
• Key commitment in GPFV to deliver a major international
recruitment drive to attract up to 500 appropriately trained and
qualified GPs from overseas by 2020
• M&E funding allocation £6m - maximum of £36,000 per head
• Target 166 FTEs
- Lincolnshire – 28 GPs recruited
- Essex – 3 GPs recruited, more expected this year

55. Stabilising and transforming services for the future
Key GPFV Initiatives
Clinical Pharmacists
• The region’s target for recruitment of Clinical Pharmacists is
444
• Central investment of £112m to extend pilot programme
• M&E workforce achievement
- Wave 1 – 142
- Wave 2 so far – 60.3 WTE

56. Stabilising and transforming services for the future
Key GPFV Initiatives
Career Plus Pilot Sites
• National pilot to review a range of models with a lead provider
working at scale that employs a pool of GPs
• Targeted at GPs at risk of leaving the profession, with the aim
of retaining their skills and experience
• £100k for pilot sites
• Likely be transferred via the regions using the NHS England
Standard Contract to contract with the pilot sites

57. Stabilising and transforming services for the future
Governance

58. Stabilising and transforming services for the future
Workforce Governance Structure
Workforce Sub Group will be driven by NHSE and HEE and will
oversee delivery of Midlands and East workforce targets
reporting progress to the National 2020 Delivery Group and
Midlands and East Regional GPFV Sub-Group.
Brings together four DCO Workforce Leads to enhance and
support development of workforce plans at STP level,
resolving risks and issues and sharing best practice and
knowledge

59. Stabilising and transforming services for the future
Risks to Delivery
• The numbers – targets versus actual demand requirements
• Workforce numbers are not met due to limitations of national criteria
for some GPFV Schemes
• Uptake of GPFV initiatives by primary care providers
• Recruitment, retention and return to work

60. Stabilising and transforming services for the future
Next Steps
• Firm up NHSE/HEE workforce partnership deliverables
• Open up a dialogue with key stakeholders (STPs/LMCs/RCGP)
about workforce
• Help STPs to progress workforce plans through our GPFV
transformational teams
• Create workforce support packages