Planning guidance – implications for primary care

5 January 2016

The planning guidance for the NHS was published just before Christmas, but read nothing more into this timing than a desire to give local commissioners and providers as much time as possible to digest the document’s contents and meet the tight deadline to prepare local plans – the first of which need to be delivered early next month.

Delivering the Forward View: NHS planning guidance 2016/17 – 2020/21 is significant for several reasons. It spells out how a national set of local five year plans will be produced to underpin the Five Year Forward View (not itself a plan, remember). It also sets out overall NHS funding for the period in line with commitments made by the Chancellor in the autumn spending review.

The document’s emphasis on “place-based” planning marks the first steps away from funding by organisation and care sector to funding for populations.

Commissioners, providers and local authorities are expected to work together to determine local “transformation footprints”, the planning and funding units of the future. NHS England expects to be able to map these interlocking forms – with no gaps or overlaps – within a few weeks. 

Each area will be asked to draw up a sustainability and transformation plan staking its claim to a share of the sustainability and transformation fund – a national pot worth £2.1 billion in 2016/17 and rising to £3.4 billion by 2020/21.

The guidance signals an end to separate funding arrangements for the confusing array of national schemes - vanguards, Prime Minister’s GP Access Fund, pioneers and so on. As the guidance puts it, “this step is intended to reduce bureaucracy and help with the local join-up of multiple national initiatives”.

These schemes will continue to be separately funded in the 2016/17 financial year.

Implications for primary medical care

STPs must cover every area of existing CCG or NHS commissioned activity, including primary medical care, irrespective of existing delegation arrangements.

Primary care figures strongly in the targets set for local leaders. By March 2017, “20% of the population will have enhanced access to primary care”, meaning access to out of hours services, including GP out of hours services, and weekend access to GP services.

Every area is required to start the 2016/17 financial year with “a local plan to address the sustainability and quality of general practice, including workforce and workload issues”. This is one of the nine “must dos” for every local system.    

Local plans for GP services are reflected in the government’s commitment to increase funding for primary care by 4% to 5% each year to address the well-documented problem that primary care investment has fallen behind other parts of the NHS.

Funding allocations for CCGs have been set for the next three years, and there is a further pledge to publish the allocations for primary care making it easier to hold commissioners’ spending commitments to account.

STPs must focus on three challenges – closing the health and wellbeing gap, closing the care and quality gap and closing the finance and efficiency gap – and local plans are expected to address a number of questions under each heading. The second (the care and quality gap) focuses on the development of new care models and digital healthcare.

Local plans will be expected to go into detail under this heading on plans for sustainable general practice and wider primary care, enhanced access to GP services and use of technology. The latter includes improved use of online GP appointment systems and repeat prescriptions, but planners are also expected to say how they will expand their “online offer” to include GP consultations and other unspecified services. 

Commissioning Briefings

Latest News

Health and safety e-learning

31 May 2016

Responsibility for health and safety in an organisation typically lies with appointed managers. However, there are health and safety issues that everyone needs to be aware of, from the fire evacuation procedure to lifting a box correctly.

This e-learning course looks at how to comply with health and safety regulations and also what every member of staff should be aware of in the work environment.

Read More

Dental contracting essentials level 2

31 May 2016

Building on the understanding gained at our dental contracting essentials and from real work examples, these half day sessions will take delegates through scenarios they are likely to face as contracting managers.

As part of the sessions on 1 November in Leeds, 2 February 2017 in London and 14 June 2017 in Birmingham we will be asking delegates to provide queries they would like to work through regarding approach and decision making.

Read More

Do the BMA's tactics matter?

31 May 2016

An HSJ scoop reveals that parts of the BMA leadership were intent on dragging out the junior doctors' strike, even to the extent of forcing Jeremy Hunt to impose the new contract - the very thing the BMA blamed for getting in the way of a resolution. Do the motives or tactics or the union's leaders really matter? Vote on this week's NHS Networks poll at

Read More

Conflicts of interest

31 May 2016

Clinical commissioning groups (CCGs) manage conflicts of interest as part of their day-to-day activities. Effective handling of conflicts is crucial for the maintenance of public trust in the commissioning system. Importantly, it also serves to give confidence to patients, providers, Parliament and taxpayers that CCG commissioning decisions are robust, fair, transparent and offer value for money.

PCC and Kennedys Law have designed this workshop on 22 July in London to look at both corporate and individual accountability of commissioning organisations. It will help you to understand your responsibilities, put them in context within the healthcare environment and know what that means on the ground when making commissioning decisions.

Read More

Primary medical services directions: SFE update

27 May 2016

The General Medical Services statement of financial entitlements has been updated.

Read More