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Independents' Day

Accountants warn of losses on hours DES

By Gareth Iacobucci

GPs should brace themselves for significant financial losses under the Government's contract offer even if they do choose to provide extended hours, accountants are warning.

Under the deal on the table, practices that refuse to offer extended hours stand to lose an estimated £18,000 a year. But accountants fear GPs who do offer evening and weekend appointments will also lose out.

The warning came as the GPC said some practices might be better off ‘taking a hit' by refusing to do the DES, because the incentives offered might not cover expenses.

Bob Senior, director of medical services at accountancy firm BKL Tenon, said the extended access DES was unlikely to cover the cost of GPs, staff and premises.

He said: ‘If you were looking at a salaried GP, they're probably looking at £8,500 a session, so that's coming in at something like £10,750 to provide a salaried GP session a week over the course of a year. That leaves you £7,000 for all the other staff costs. There's not going to be much money in it at all.'

Paul Samrah, a partner at Kingston Smith accountants, predicted practices would be forced to make cuts elsewhere to balance the books. ‘They could limit the number of staff on duty, give time off in lieu and look at energy saving,' he suggested.

A number of LMCs have warned GPs they might be better off foregoing the DES entirely.

A Gloucestershire LMC circular warned: ‘It is strongly felt the DES will be uneconomic to operate, as the payment for it will not cover the costs, staff, heating expenses and so on. The GPC does not anticipate any doctors will in fact wish to take part.'

GPC negotiator Dr Chaand Nagpaul insisted the GPC had not made any formal recommendations, but admitted ‘taking a hit' may be a ‘very reasonable choice to make for some'.

Dr Susan Davies, a GP in Chard, Somerset, said the extended access DES failed to allow for the cost of funding practice nurses and other staff. ‘It's not necessarily the GP who is required for these extended hours. I can't think when I last did a smear test. My nurse does all that kind of activity now.'

Cost of offering extended hours

Estimated cost of not providing extended opening under the offer – £18,000

• Cost of providing extended opening under Government's offer
– Cost of GP's time – estimated at £10,750
– Cost of clinical and administrative staff (premium rates for antisocial hours)
– Heating, lighting and other premises costs


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