Supporting General Practices During Winter

Dear West Yorkshire LMC Executive,

Thank you for your letter of 16 December 2022 and our subsequent discussion on the 9 January 2023 regarding system pressures support for General Practice. We absolutely acknowledge the pressures faced by General Practice and are grateful for the commitment and responsiveness shown.

Your letter requested that the NHS West Yorkshire Integrated Care Board (NHS WY ICB) consider income protection for the Quality and Outcomes Framework and Investment and Impact Fund to free up capacity to support urgent care demands. We have made representations to NHS England on this matter, and they have informed us that these issues are nationally agreed and there is no scope for local flexibility. Please be assured that we will continue to work with NHS England and make the case for support for General Practice during these times. If the national position changes, we will of course work with yourselves and local clinicians to review what can be done.

Following discussions at the West Yorkshire System Leadership Team meeting on 11 January 2023 we are able to repurpose £1.4m of Sustainability and Development Funding (SDF), which will be allocated to place on a fair share formula in January 2023. We will ask place and primary care leads to work locally with LMC colleagues to reach agreement on how this funding can be diverted with consideration to winter pressures and local transformation priorities. We will also ask that primary care leads work with LMC to agree the local communications to General Practice.

We hope that this funding will help practices prioritise and maintain a balance of managing routine long term condition care and urgent access which is key to supporting recovery so that all patients continue to receive the best care. We will of course continue to reiterate and support messages through system communication channels encouraging patients to make the right choices when accessing care. We also recognise that General Practice workload can be impacted through actions in secondary care, and the West Yorkshire System Leadership Team (which includes place leaders and secondary care colleagues) are discussing how this can be progressed, building on the existing programmes of work at West Yorkshire and at place. This will focus on what can be done to enable improvements in the primary to secondary care interface.

Finally, it is important that we recognise that different places currently have different approaches to measuring pressures that General Practice is facing. We would like to ask for LMC support to help develop a system wide approach built from best practice locally and informed by recent regional work. This will cover both an evaluation of pressure and a description of the support and actions that can be taken. This will also allow us to make a stronger case for additional national support and evaluate the difference that local support packages are making.

Thank you for your time and support to General Practice in their efforts and continued hard work during this very testing time.
Yours sincerely,

Rob Webster CBE, Chief Executive, NHS WY ICB
Dr James Thomas, Medical Director, NHS WY ICB