Background
Across NW London, we want patients to know they will get high quality, timely, care at their local GP practice.
The NW London Improving access specification aims to support general practice services to develop models which build resilience and make effective use of resource. This should mean better access, best use of clinical time, reduced waiting times, and increased continuity and proactive care for those that need it. The first year of delivery will focus on the responsiveness of general practice, build the foundations of a model to provide high quality continuity of care, and drive better use of digital tools to promote access.
Access Improvement plan
To support improvement across the system, the access specification in 2025/26 NW London ICB asks PCNs to work with their constituent practices to develop access improvement plans.
This plan will need to be submitted to the ICB by 30th June 2025 at the latest. Submission of this plan is a condition of the release of payment to PCNs. PCNs are encouraged to use the template below and attached to complete their plans, but submission in other formats will also be accepted.
Plans will not be subject to formal assessment, but checked to ensure that they include:
- an overarching model for access that describes how the PCN will meet the requirements of the specification, outlining what will be developed/delivered at both PCN and practice level
- a locally-agreed approach to triage and navigation – with a focus on managing same day and next day demand
- detail of the internal Standard Operating Procedures to managing online consultation – including safety netting to ensure urgent online consultations are dealt with in a timely way
- plans to engage with patients throughout the year and how engagement responses will be fed back into service improvement
- detail of how funding will be apportioned to support delivery
- local measures of success
- expected timeframes for delivery
- consideration of how these plans will improve health equity
In developing their plans we would expect PCNs build on local data on both demand and capacity and a sound understanding of the demographics and clinical needs of their population. PCNs should reflect on whether they have the right skills, knowledge and infrastructure they need to support the delivery of high-quality care and should make reference to the model of modern general practice. The plan should include the activities, and assessment measures that will be used to drive improvement. It should also be clear on who is responsible for delivering against each of the activities and the timeframes for doing so.
The seven practices in Greenwell PCN work closely together in order to achieve an equitable and high quality service to the 40,000 patients in the locality. The CDs, PCN staff, and PMs meet monthly to share good practice, discuss the delivery of new initiatives and to ensure that all the practices are meeting local and national targets.
The PCN aims to ensure all registered patients can access appropriate Primary Care appointments with the correct clinician within reasonable time frames by reviewing appointment structure, clinicians and services available, working with health and social care providers supporting primary care within North West London.
We aim to ensure all patients are triaged and signposted to the most appropriate time; type of consultation and health care professional to manage the patients request according to clinical need.
All practices have SOP’s which underpin processes for online consultation.
The PCN offers extended hours to all the patients and invests in remote clinicians to provide same day telephone consultatins. The PCN’s approach to delivering primary health care is the correct approach for a small PCN with a growing population, the practices face the challenges of a highly diverse population, with many minority cultures and the same inner city issues that all London practices experience. Working together to provide quality health care, accessible to all with a strong focus on ‘need’ being met by the correct clinician, offering same day or next day appointments for urgent cases.
Approach to Improvement
| Measures | Baseline | Change required | How this will be achieved |
| 90% of calls answered within 10 mins | 90% achieved across all practice | No change required | All practices will continue to monitor and ensure they maintain their high standards. |
| 90% of e-submissions are responded to by end next working day. | For all practices the majority are dealt with on the same day – all by the end of the next working day | No change required. | All practices will continue to monitor and ensure they maintain their high standards. |
| SNOMED coding in the appointments ledger to record direct clinical care | To use snomed coding for non-ledgered direct clinical care or MDT case discussion. Snomed used for Pharmacy First | Accessibility monthly audit available from June 2025 | Summaries will be discussed in PCN meeting to share ideas |
| Audit of use of clinical time | Accessibility audit | Accessibility monthly audit available from June 2025 | Summaries will be discussed in PCN meeting to share ideas |
| Continuity flag for at least 2% of the patient list is in place | To use snomed code for Optimisation of clinical care till TPP is ready with the code for provision of continuity of care | To undertake one off continuity audit of high-risk patients (Nov 25-Jan26) to be submitted by 13/3/2026 | The PCN will discuss review finding and submit summary and action plan |
| Review of a 10% sample of the identified population | |||
| Increase registrations on the NHS App by 10%, or locally agreed measure | The 7 practices currently have differing percentages of patients using the NHS APP | All practices committed to increasing uptake by 10% | Advertising the NHS on websites; posters I waiting rooms; added to text messages; reminders in F2F and telephone consultations. |
| Patient engagement via annual survey and engagement event | Annually | Finding discuss with PPG and PCN | Annual survey by practice, PCN wide engagement event and feedback to patients. |
Patient Engagement
Greenwell PCN plans to continue to engage with patients via FFT survey; practice PPG, PCN wide F2F PPGs; websites, the various social forums we run i.e. Coffee and Chat, Walk and Talk.
We will do a survey in Q4
We ensure patients are involved by listening to their ideas and looking at how we can implement workable suggestions.
PCN staff are highly visible throughout the practices and have an open door policy encouraging patients to ‘talk to us’.
Costs
| Workstream | Resource required | Costs | Timescale |
| Minor illness appointments | Medloop- remote minor illness- | £3528/ week ( 294 appts) | ongoing |
| Pharmacy first training | Reception engagement | n/a | 3 months |
| Rebuild community groups | Voluntary sector engagement; room hire | TBC | TBC |
| Patient education- who should I see | Posters/ website | TBC | 3 months |
Expected Outputs
| Benefit | Measure | At Practice or PCN? | Data Source | Baseline | Target | Timescale |
| 294 minor illness appts | appts | PCN | Apt search | Would be zero if we did not fund this | 294 appts | ongoing |
| Divert patients to pharmacy | Pharmacy first appts | PCN | Snomed codes | Increase by 10% | March 2026 | |
| Correct person seen first | Audit of appts use | PCN | Monthly audit | March 2026 |
Health Equity
Access to minor ailments available to all- we have enabled use of silent sounds translators for medloop clinicians seeing our patients,
Community groups will make use of translators (voluntary and within our PCN staff) to ensure that all sectors of population can engage.
Bernadette Guneratne
Greenwell PCN Manager
June 2025