Access Requirement 2023

In May 2023, the GMS and PMS contract underwent revisions to incorporate changes regarding access to GP practices as per the updated regulations. The revised regulations state the following:

1. The contractor must take necessary measures to ensure that a patient contacting the contractor does so through one of the following means:

(a) Physical attendance at the contractor’s practice premises.
(b) Telephone communication.
(c) Utilization of the practice’s online consultation tool.
(d) Use of a relevant electronic communication method.

2. The appropriate response from the contractor must involve one of the following actions:

(a) Inviting the patient for an appointment, either at the practice premises or through a telephone or video consultation, at a time that is suitable and reasonable, considering all circumstances, without jeopardizing the patient’s health.
(b) Providing appropriate advice or care to the patient through alternative means.
(c) Directing or inviting the patient to avail themselves of appropriate services available, including self-accessible services.
(d) Communicating with the patient to request additional information or to inform them of when and how they will receive further information regarding the services that may be provided, taking into account the urgency of their clinical needs and other relevant circumstances.

3. The appropriate response should be provided as follows:

(a) If the contact specified in paragraph 1 is made outside of core hours, the response must be provided during core hours.
(b) In any other case, the response should be provided on the same day as the contact during the core hours.

4. The appropriate response must consider:

(a) The patient’s needs.
(b) When applicable, the patient’s preferences.

Practices implementing care navigation to allocate patients to appropriate services may adopt various dispositions for patients who contact the practice, as outlined in paragraph 2:

– Offering on-the-day assessment by another clinician for cases perceived as urgent.
– Providing assessment at a later time by a clinician for cases related to longer-term and non-urgent conditions.
– Referring patients to another service if it is deemed appropriate, such as mental health support, community services, or community pharmacies.
– Directing patients to utilize 111, urgent treatment centers, or overflow hubs when practice capacity is exceeded.
– Requesting further information, for example, through available digital tools at the surgeries.

Paragraph 2 does not specify a specific time frame within which a further assessment or appointment should be offered; it states “at a time which is appropriate and reasonable, considering all circumstances.” However, QOF (Quality and Outcomes Framework) and IIF (Investment and Impact Fund) targets aim to ensure that patients are seen within 14 days of contacting the practice. While some practices may achieve this target, it is not considered a breach of the contract if practices are unable to meet it.

Paragraph 3a states that practices must respond to contacts made “outside core hours” during the following core hours. However, practices have the option to disable online consulting methods outside core hours to allocate more capacity for responding to in-hours contacts (8am-6.30pm, Monday to Friday).