Enhanced Access

About this document

This document explains how the local NHS intends to develop enhanced access services. This development will continue to provide the best possible treatment for our residents whilst making services sustainable for the future.

SWAGGA Primary Care Network is a collaboration of 17 GP Practices geographically aligned and working together to improve patient care. SWAGGA PCN has a weighted patient population of approximately 105,000 patients. It is a very large Network with a diverse population and patient needs.

Introduction

On 1 July 2019, GP practices across England began working with other practices in their local area in groups called Primary Care Networks (PCNs).

PCNs were announced as part of NHS England’s Long Term Plan in January 2019. They have been put in place to improve and extend the range of services that are available in the community and join up the care that is provided from different organisations. It is expected that by practices working together with a range of local providers, including community services, social care and the voluntary sector, they will be able to make resources go further.

Purpose of this Engagement

On 1st March 2022, NHS England published the updated GP contract regulations for 2022/23. The contract includes arrangements for a new enhanced access service, which is the further development of two existing services, know as extended hours service and extended access service (further information can be found below). This new service aims to improve patient access to primary care.

What is Enhanced Access?

Until recently, all GP practices had to provide some additional appointments every week before or after normal opening times for their own patients; this was known as extended hours. In addition, Clinical Commissioning Groups (now renamed as Integrated Care Board or ICB) must make sure that patients can access appointments with primary care clinicians and staff in convenient locations across the city again outside of the core hours, this is known as extended access. From 1st October 2022 these two services (extended hours and extended access) come together and form one service that will be known as Enhanced Access.

What is Extended Access?

Extended access to primary care was introduced by NHS England in 2016 to ensure everyone had easier and more convenient access to GP services, including physical and digital appointments at evenings and weekends. Extended access was the offer to registered patients of a GP practice, of pre-bookable ROUTINE appointments outside of core contractual hours, either in the early morning, evening or at weekends. These appointments were provided at a location in the network where you live. PC24 delivered this service on behalf of PCN practices.

What is Extended Hours?

The Extended Hours Service is a requirement of the Network Contract Directed Enhanced Service (Network Contract DES) which was first introduced on 1 July 2019. This service was delivered directly by GP Practices, offering additional appointments outside of Primary Care Network (PCN) member practices core contracted hours, to all registered patients within the PCN. These emergency, same day or pre-booked appointments are offered to patients via a mixture of methods, including face-to-face, by telephone, video and/ or online consultations.

Why are we changing services?

The NHS has been changing a lot recently, with new initiatives and organisations being developed by the Government.

Currently Clinical Commissioning Groups (CCGs) were responsible for commissioning (buying) the extended access service.

With the national developments of Primary Care Networks (PCNs), explained below, the funding and responsibility for extended access must transfer from the CCG to the PCNs by October 2022. The new service will be known as enhanced access and is a combination of extended and enhanced access services.

NHS England have said “The new enhanced access arrangements aim to remove variability and improve patient understanding of the service. The new offer is based on PCNs providing bookable appointments outside core hours within the Enhanced Access period of 6.30pm-8pm weekday evenings and 9am-5pm on Saturdays, utilising the full multi-disciplinary team, and offering a range of general practice services, including ‘routine’ services such as screening, vaccinations and health checks, in line with patient preference and need.”

The PCNs are looking at the current service and reviewing how it can be improved so that as well as providing the services patients are used to getting during these extended hours that, over time, additional treatments and services may be offered.

The PCNs are also looking at potentially changing the venues so the service is more local to patients. The PCNs want to make sure that the service, which is offered, meets the needs of the patients registered in a SWAGGA PCN Practice.

What will the proposed changes mean to me?

SWAGGA PCN is engaging with patients registered in one of our 17 GP Practices via Patient Participation Groups and through feedback from the engagement questionnaire, which will be given back to the subcontractor (plan is preferred current provider PC24) who can use this information to ensure services suit patients.

Types of appointments that could be offered include:

➢ Smear tests
➢ Diet and lifestyle advice
➢ Musculoskeletal Problems
➢ NHS Health Checks
➢ Weight management
➢ Chronic disease reviews

There will always be a GP present on site during all appointments. Appointment types will be a mixture of face to face and remote consultations. The appointment types will be delivered by a mix of GPs, Practice Nurses, Advance Nurse Practitioners and Health Care Assistants. It is the intention of the service that it uses a wide variety of roles and skill mix to ensure the service is resilient whilst meeting the needs of patients.

Feedback from our patients will be given to the CCG/ICB and also to the preferred provider for the subcontracting of the service. This will enable them to take patient engagement into consideration when planning ahead on the design of the service model to suit the needs of the population.

Potential benefits

SWAGGA Primary Care Network Practices are keen to ensure that the revised enhanced access service meet the needs of patients both in terms of health care provision and accessibility and convenience. Some of the main benefits are:

➢ Patients will have additional non-urgent access to more local primary care services than are currently provided. Whilst the appointments in the enhanced access services are for non-urgent appointments, we hope that this will free up access to more urgent, same day and pre-bookable appointment slots in practices
➢ More appointment types will be available with the primary health care team
➢ With this greater flexibility in managing appointments outside of core hours, the PCNs hope to be able to meet the needs of patients who would prefer appointments at their own GP Practice within core hours
➢ By providing more appointments in a convenient location and the provision of appropriate and safe systems of primary care in the community, there should be a reduction in the number of patients incorrectly visiting A&E. This is good for everyone.
➢ Access to the appointments will not change and patients will experience minimal disruption, but you will be offered appointments within your own Network and there will be additional appointments available for all patients registered with a SWAGGA PCN GP Practice in the evening and across the weekend.

How you can give us your views

We are looking for your views on the new enhanced service with a formal patient engagement. When visiting the surgery please pick up a copy of the survey, complete and pass it back by handing it in at the Practice or complete this online version.

A report will be given to ALL practices in the SWAGGA PCN which will show data for all responses. Practices will display this report on their websites and in the waiting room to show transparency and openness in patients needs and opinions when submitting the data to the planned service provider and the commissioners.

Should you need support in filling in your questionnaire please ask at reception.