Written question WQ93069

As independent contractors, GP practices are responsible for their own staffing. Health boards, as contracting bodies, are responsible for ensuring practices deliver services to their contractual obligations. GP practices use the Wales National Workforce Reporting System (WNWRS) to record staff details, such as role and time commitment, and this information is extracted and shared with health boards on a quarterly basis.

The self-reported General Practice Escalation Tool enables practices to alert health boards to significant staffing issues such as sickness. Health boards are also able to track staff sickness levels through high-level management data through the Primary Care Information Portal, which is managed by Digital Health and Care Wales (DHCW).

Over recent years, Welsh Government initiatives have helped to ensure the current recruitment target of 160 new GP trainees each year is consistently being exceeded, and have significantly increased the wider general practice direct patient care workforce.

We do not collect data on the number of days of practice closures due to sickness.

Through the GMS Access Standards, practices are encouraged to engage with patients, conducting an annual patient survey to seek feedback on service delivery. Practices are required to reflect on the results in an annual report as well as regularly providing information to patients on the services provided through a public-facing dashboard.

Chronic disease management, through the call and recall of patients, with regular monitoring and advice, is a core remit of General Medical Services. Practices are responsible for the establishment and upkeep of patient disease registers and clinically appropriate patient review, in line with national clinical guidance and professional best practice.

While GP practices are responsible for their own appointment systems, the Access Standards require practices to:

• Ensure a mix of remote, face to face, urgent, on the day and pre-bookable appointments.

• Maintain a planned and forward-looking approach to the scheduling of appointments throughout the day, or for future dates, meaning it is no longer acceptable for all appointments for that day to be released at 8am.

• Collect patient feedback and use this to develop an access improvement plan, taking into account how they have engaged with patients.

We are investing £12m over three years from April 2022 to help GP practices build their capacity through additional staff to support improvements to access. Further investment of £3.7m for digital telephony improvements was included in the 2019-20 contract agreement. Following this, the new Unified Contract introduced last year has made it a contractual requirement for practices to have appropriate telephony and call handling systems in place which support the needs of callers and avoids the need for people to call back multiple times.

Through the new contract, we have also made it a requirement for practices that people are able to request a non-urgent consultation through a digital method of access. This complementary access method will reduce the number of phone calls to practices, ensuring that people who contact the practice by phone can have their call answered more quickly.

The new contract also specifies the hours during which people must be able to physically access their practice in order to make an appointment, should they wish to do this in person.

Practices are responsible for providing an appointment booking system that meets the needs of their patients and must make a quarterly declaration against the access standards. The declaration is verified by the health board and forms part of the dataset that underpins the assurance framework indicators used to prioritise contractors for annual contract and governance practice visits.