Same Day Access proposals in North West London – 1 March update

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This message, including our analysis document, was shared with practices in North West London and is available here for wider reference.

Thank you for continuing to feedback your thoughts and views on the North West London proposals regarding Same Day Access. We fed back your concerns to the ICB in our letter of the 9 February 2024 and their full response is included in an appendix to this report.

After seeking further clarification from the ICB, the attached analysis captures our remaining concerns. Please note that this analysis is based on the information that has been shared with practices by the ICB through presentations, letters to CDs and initial workshops to date and we continue to discuss ways in which proposals might be adapted to address those concerns.

The LMC analysis sets out indicative actions for LMCs and for practices, reflecting the outstanding concerns from constituents, as well as patient groups and wider stakeholders who have reached out to us. Whilst these indicative actions may change as discussions with commissioners continue and develop, we want to operate as transparently as possible and provide you with our best analysis based on the information shared to date. We will, of course, continue to update you as ongoing discussions with the ICB progress:

  • We have particularly focused on clinical safety, proposed timescales, and the link to the single offer, and have had early discussions about the principles that the ICB has stated are fundamental for the hubs to run effectively and meet patient demand.
  • We have suggested to the ICB that there would be benefit from understanding what practices and practice networks have already put in place regarding same day access and the learning of what has worked well and the trade-offs for patient care. We have also suggested that there would be merit in further exploration of the opportunities, challenges and impacts of their key design principles with both providers and patients, eg the evidence base for the effectiveness of the proposed standardised triaging of same day demand at scale, across practices serving people of different demographics.

ICB leads have indicated that they have reflected on the feedback and are actively looking at how we can move forward positively.

We will be continuing these discussions, focusing on providing assurances about flexibility of approach, timescales for delivery, sharing of learning and outputs from Wave 1 sites as well as addressing wider system pressures which are impacting on our ability to provide the care we want for our patients, such as inappropriate workload transfer to general practice. The goal is to secure and deliver the funding for general practice in a way that works for practices and patients.

We will keep you updated on the outputs of these discussions.

Footnote: Your practice will have received correspondence from the ICB regarding Same Day Access on 19 February. A longer version of that letter was sent to the LMC and is linked below for completeness, along with other documents referenced in the attached analysis document.