Fuller report to inform NHS England approach to practices’ role within ICSs

The review of general practice by Professor Claire Fuller has moved from being a ‘stock take’ of how ready the service is for NHS England’s integration agenda to looking at what changes can be made to implement integration. 

In a panel event hosted by Policy Exchange on 20 July Prof Fuller spoke about ‘stocktake implementation’. She reiterated her view that the best way for general practice to meet current patient need is through working in neighbourhood teams with other services to deliver care where people live, avoiding siloed working. She also suggested ICSs should put neighbourhood teams in place for the most deprived areas by April 2024, to address the inverse care law. 

In explaining what factors she was considering when making her recommendations Prof Fuller did note that the remit of her report had specifically excluded examining possible changes to funding, the partnership model and the GP Contract.  

Prof Fuller told the audience that there should be provision for continuity of care to be traded off for immediacy of care for some acute presentations where patients are happy to do so. Although those accessing care episodically who would be better served by continuity should be identified and offered continuity, she gave the example of a person with addiction seeking episodic care and therefore not receiving continuity. 

 Prof Fuller also mentioned: 

  • Flexible working is important for retaining GPs, giving an example of having a term-time only contract to allow parents to remain in the workforce. More widely she spoke about the importance of creating a good working environment. 
  • General practice cannot just have more tasks added to it without expanded capacity or removing some existing obligations. 
  • Local organisations should have the freedom to look at alternative models where GPs cannot be found to take on a contract that has all its existing parners resigning or retiring.