Community care boost to bring treatment closer to home - Conservatives

The Conservatives are today (Sunday 2^nd June) announcing that they will bring more care services into the community as part of our plan to secure a modern NHS for the future. 

The new plan will: 

• Expand Pharmacy First to: offer women more contraceptive options, deliver menopause support; and provide treatment for more conditions, such as acne and chest infections – all without needing to see your GP, and wherever you live in the country. The expanded Pharmacy First scheme will free up 20 million GP appointments in total, once fully scaled.  

• Build or modernise 250 GP surgeries – 100 new GP surgeries and 150 GP modernisations, focused on the areas of greatest need, and particularly those areas experiencing new housing growth.  

• Build 50 new Community Diagnostic Centres – on top of the existing programme that has delivered 160 in this Parliament – delivering a further 2.5m checks and diagnostic tests a year once scaled up. 

This clear plan, paid for by cutting back the number of NHS managers to pre-pandemic levels and halving management consultancy spend across government to get more money to the front line, is fully costed and will dramatically improve how people are treated to secure the future for our NHS.   

As part of our plan to pay for the new GP surgeries, we will overhaul planning guidance to ensure health gets a bigger share of developer contributions from new housing developments. 

The action we are announcing today will make it easier to access treatment and services without having to book a GP appointment. And by allowing pharmacies to offer more treatments without a prescription, we will free up GP capacity - making it easier to see your GP when you need to. 

Our 160 Community Diagnostic Centres have already delivered an extra seven million checks and tests, including for conditions such as cancer. Under our new plan, there will be a further 50 new Community Diagnostic Centres on top of the existing programme, with the majority delivered by the independent sector. These centres will deliver a further 2.5m checks and diagnostic tests a year once scaled up. 

Rishi Sunak, Prime Minister said: 

“The NHS is one of our most important national assets and the Conservatives are taking the long-term decisions to secure its future.  

“As part of our clear plan we are investing in community services making it quicker, easier and more convenient for patients to receive the care they need and help to relieve pressure on hospital services.  

“Only the Conservatives will take the bold action needed to secure the NHS's future so that you can be safe in the knowledge that the NHS will be there for you and your family whenever you need it.” 

Victoria Atkins, Health Secretary said: 

“Pharmacies, GPs and Community Diagnostic Centres are the backbone of our NHS. Because of bold action we have taken, they are more accessible in more places for more people.     

"I know just how important it is for people to have access to health services and treatment close to home - and Pharmacy First and our hundreds of new Community Diagnostic Centres have been a real success story so far. But we must do more.  

“Our clear plan will continue to enable our brilliant pharmacists, GPs and CDCs to do what they do best: serving their local community and boosting capacity in our NHS. We will make the NHS faster, simpler and fairer for all.” 

ENDS 

For further information, please contact the Press Office on 020 7984 8121 or email us atpress@conservatives.com.  

Notes to Editors 

• We have achieved our 2019 manifesto commitments to deliver 26,000 more professionals working in primary care and 50 million more GP appointments. In the 12 months to March 2024, there were over 60 million more appointments in 2023-24 compared to 2019-20 (NHS England,Millions more GP appointments in April than before pandemic, 30 May 2024; link). The number of health professionals working in primary care is now over 36,000 higher than in March 2019 (NHS England, Delivery plan for recovering access to primary care: update and actions for 2024/25, 9 April 2024; link). 

• We launched Pharmacy First in 2023-24: since 1 December 2023, thousands of women have been able to get their contraceptive pill from their local pharmacy and millions more life-saving blood pressure checks have been made available; and since 31 January people have been able to go to their pharmacist instead of their GP for seven common conditions: sinusitis, sore throat, earache, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections in women (DHSC,Pharmacy First: what you need to know, 1 February 2024; link).  In February 2024 alone, 125,275 Pharmacy First consultations took place in England (NHSBSA, Dispensing contractors' data, 25 May 2024, link). 98% of pharmacies have signed up to Pharmacy First (Hansard, 23 April 2024, link), 4 in 5 people are within a 20-minute walk of a pharmacy (DHSC, Pharmacy First: what you need to know, 1 February 2024; link), and there are just over 10,500 NHS community pharmacies in England (NHSBSA, Pharmacy data, April 2024, link). Once fully scaled, the current scope of Pharmacy First will save 10 million GP appointments a year (DHSC, Pharmacy First: what you need to know, 1 February 2024; link). 

• We delivered 160 new Community Diagnostic Centres through our £2.3 billion programme one year early – with 160 sites operational from April 2024. They have delivered seven million checks to date, and represent the largest cash investment in CT and MRI scanning in the history of the NHS (DHSC, Diagnostic checks rolled out to 160 sites under CDC programme, 11 April 2024, link). CDCs help to reduce pressure on hospitals and allow for a speedier diagnosis, so patients receive potentially life-saving care sooner.  Many of these CDCs are provided by the independent sector (DHSC,Government boosts use of independent sector capacity to cut NHS waits, 4 August 2023, link). 

• Under the NHS Long Term Workforce Plan, which we are backing with £2.4 billion, we are: increasing the number of GPs in training by 50% - from 4,000 in the baseline year of 2022 to 6,000 by 203l and increasing the number of pharmacists in training by almost 50% - from 3,339 in 2022 to 4,970 in 2031 (NHS England, Long Term Workforce Plan, 30 June 2023; link). 

• Our £3.4 billion NHS Productivity Plan will help reduce the time frontline workers spend on administrative tasks, increasing NHS productivity to an average of 1.9% per year between 2025-26 and 2029-30 and unlocking £35 billion in cumulative savings (HM Treasury, Spring Budget 2024, 6 March 2024; link). 

Our Plan 

• We will expand Pharmacy First to free up an additional 10 million GP appointments – 20 million in total – to cover more conditions, such as acne and chest infections; offer contraceptive patches and injections, in addition to the oral contraception already available; and provide menopause support, including HRT. As with the current Pharmacy First scheme, implementation will be guided by and subject to clinical advice. 

• We will also invest in 250 new and modernised GP practices. This funding will be used to modernise and upgrade 150 GP practices and to build 100 brand new GP surgeries, located in the areas of greatest need, and particularly in areas of new housing growth. This new physical infrastructure for primary care will support our ambitions to grow the general practice workforce and offer more care in the community outside of secondary care settings – ultimately keeping more patients out of hospital. In order to reduce costs of the new GP estate, we will: use repeatable designs– “GP 2.0” – that can be centrally procured and rolled out at scale, harnessing efficiencies in construction; and overhaul planning guidance to ensure health gets a bigger share of developer contributions from new housing developments. Developers make contributions to local communities when new homes are built via Section 106 agreements and the Community Infrastructure Levy. The Conservative Government recently legislated via the Levelling Up and Regeneration Act to consolidate these charges into the Infrastructure Levy, so that communities see a fairer contribution towards the delivery of infrastructure that must come with new homes. We will change planning guidance to ensure health gets a bigger share of these developer contributions 

• We will build 50 new Community Diagnostic Centres, delivering 2.5m more checks every year for conditions like cancer when fully operational. There will be at least seven new CDCs in each NHS region, with the exact locations to be determined by a competitive bidding process. To support innovation in delivery, we anticipate the vast majority of these CDCs will be provided by the independent sector. 

How we will pay for this 

• Delivering the expansion of Pharmacy First, GP surgeries and Community Diagnostic Services will, once scaled, cost an additional £1.01 billion a year by 2029-30. This is based on: average revenue costs of each of the 100 new GP surgeries being £1.5m a year (NHS Digital, NHS Payments to General Practice, England 2022/23, 9 November 2023; link); conservative estimates of the average fees and additional costs of a Pharmacy First consultation of £25 (based on the £15 fee per consultation under the current scheme, although this would need to be negotiated with the sector (NHSBSA, NHS Pharmacy First Service, 31 January 2024; link)); and conservative estimates of the average cost of a test in a Community Diagnostic Centre of £200 (the average cost of a nuclear medicine, imaging and direct access diagnostic test in 2021/22 was under £100: NHS England,2021/22 National Cost Collection Data, undated; link). Capital costs of the new and modernised GP services and CDCs, net of housing developer contributions, will be spread over the period 2025/26-2029/30.  

• We will pay for this additional expenditure by: cutting back the number of NHS managers to pre-pandemic levels – by 5,500, saving £550 million each year by 2029-30; and by introducing new controls on management consultancy spend in government, saving £640 million each year by 2029-30 – almost £1.2 billion in total. Our planned 5,500 reduction is assumed to save £100,000 per manager in paybill costs, based on the NHS Staff Earnings Estimates. In recognition of the important role that managers play in supporting operational processes and relieving pressure on doctors' and nurses' time, we will focus these reductions in the NHS organisations which provide no frontline patient care. We will also launch an immediate review of all management consultancy spend across-government – which increased during the pandemic – including existing management consultancy contracts, and apply a new set of controls limiting the use of consultants to urgent or exceptional cases for the whole of the next Parliament. This will halve spending on management consultancy, which in the latest year remains below spending in the final year of the last Labour Government. The Labour Party have also made a commitment to halve consultancy spending, which they claim would save £1.4 billion a year (iNews, 9 October 2023, link). However, under HMT costings, we have assumed this policy would more realistically save £640m a year by 2029-30 (HMT,Opposition policy costing, 17 May, link).  

The alternative 

• Labour have no plan to cut waiting lists in England. Their plan to reintroduce the Doctors' Pension Tax cut would see doctors leave the NHS. The Chair of the BMA's Consultants' Committee has said, “if there is one policy that is going to make that [the waiting list] worse, it's this one” (Daily Telegraph, Doctors quitting NHS to avoid Labour's pension tax raid, 31 May 2024; link) 

• In Labour-run Wales, hospital waiting lists are at record highs (BBC, NHS Wales waiting lists hit new record, 23 May 2024; link)