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GP out-of-hours providers struggling to cover shifts because of one-off Easter opening LESs

Exclusive GP out-of-hours providers have been thrust into competition with practices over a ‘limited pool’ of GPs to work on Easter Saturday after NHS England announced incentive schemes to keep practices open.

This comes as medical leaders reported variable uptake to local enhanced services created at short notice in response to a call from NHS England for GP practices to open for a three-hour shift over Easter in a bid to prevent a repeat of the Christmas holiday A&E meltdown.

A Pulse investigation showed that between a sixth and a third of practices were taking up LESs specially created for the weekend in areas where financial incentives were offered, while out-of-hours services will be left to tackle the whole burden elsewhere.

GPC deputy chair Dr Richard Vautrey said that in Leeds, where he is assistant medical secretary on the LMC, ‘around 20 practices’ will be opening at some point of the bank holiday weekend.

He said: ‘This scheme is supported by additional funding for those who have volunteered to take part and also links to the extended hours scheme that one of the CCGs has developed which new long-term funding they’ve invested in general practice.’

But other GP leaders warned that the one-off payment incentives coupled with smaller indemnity costs incurred when operating from the practice rather than through out-of-hours were having the unintended consequence of drawing GPs away from working out-of-hours shifts this weekend.

Devon LMC medical secretary Dr Mark Sanford-Wood said: ‘The main concern locally is that the offer may actually precipitate destabilisation of out-of-hours services.

‘Our local out-of-hours provider Devon Doctors on Call is proud that its services are largely delivered by local GP partners. Of course, if these people can earn better rates of pay for working in more protected circumstances within the structure of their own practice then they are likely to plump for that and avoid out-of-hours work over Easter which is always very difficult.’

Out-of-hours providers confirmed there was an issue, with Integrated Care 24 medical director Dr Mark Reynolds telling Pulse that it had caused ‘significant difficulty’ in ‘one or two areas’.

Dr Reynolds, whose business covers East Sussex, Brighton and Hove and Kent, said: ‘My plea is, could these ideas be thought about a bit more in advance and better coordinated, and also priced so as not to compete and draw GPs away from the service that will still be doing the vast bulk of the work.’

In Stockport, Dr Jon O’Malley, medical director of local out-of-hours provider Mastercall Healthcare warned that all providers were ‘fighting over a dwindling number’ of GPs.

He added that while they would await the CCG’s evaluation of Easter opening pilots he felt services might be being duplicated.

He said: ‘I’m not overly sure it’s going to make much of a difference. It is paying twice for the same service, that’s my concern.’

The concerns come as Pulse reported that GP recruitment problems had left more than half of out-of-hours providers struggling to fill shifts even in normal circumstances, and some out-of-hours providers did foresee problems with Easter staffing.

This included southeast London out-of-hours providers SELDOC, which offered a pay increase and confirmed rotas ‘months in advance’. However, despite this SELDOC chair Dr Emma Rowley-Conwy said that ‘a last-minute offer’ from the CCG would see Lambeth GP practices ‘very well paid’ and had resulted in 10 practices agreeing to open for four-hour shift.

She said: ‘I agree that the underlying pool of duty doctors is limited, and there is competition.’

In other areas, LMC leaders’ main concern was a lack of timely information from area teams and CCGs about incentives.

Derby and Derbyshire LMC executive officer Dr John Ashcroft said the area team has had to contact practices this week to confirm who still intends to participate in the local enhanced services.

He said: ‘It’s all been rather confusing. A lot of practices who said they would open appear now to have pulled out of this because the money is less than expected, or they haven’t been able to find staff to cover, or doctors to cover.’

In some areas, LMCs claimed no GP practices had responded to calls for extra opening.

Northumberland LMC chair Dr Jane Lothian told Pulse: ‘We don’t have a scheme. All our practices are exhausted and need a break’.

Meanwhile, lay secretary of Gloucester LMC Mike Forster said: ‘Except in Cheltenham and Gloucester, the Easter period [in our LMC area] will be covered by the new out-of-hours service which took over the contract yesterday.’

An NHS England spokesperson told Pulse local area teams and CCGs were responsible for ensuring GP services were available, but added: ‘Primary care services are vital for patients, whether delivered by GP practices or out of hours services, and across the country plans are in place to ensure appropriate services are available for patients over the Easter weekend.’

Readers' comments (11)

  • Wait until the Prime Minsters Challenge Fund kicks in properly. I've seen two winning bids and the PMCF 'winners' are planning to pay significantly more than the OOH service and on several more sites.

    OOH are going to need to pay a LOT more - which most simply cannot do.

    This will get nasty.

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  • Took Early Retirement

    Well, we can't complain; I mean, Easter is so unpredictable. Some years it happens, some it doesn't. Just like winter and Christmas really.

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  • Poor OOH private companies - having to reduce their profits to ensure safe coverage and care.

    I can see them run crying to the politicians in their pockets, about how unfair life is for them, and how they need to make more profit to justify increasing their involvement in filching profits from the NHS.

    Current OOH GP pay rates pale against calling out an OOH plumber or drain unblocker, or even in hours solicitor or accountant.

    Professional valuation of GPs needs to reflect their years of study, training and experience or shifts will end up empty and this will allow Private companies to justify staffing them with foreign cheaply sourced nurses. (No intention of denigrating our esteemed nursing colleagues - but they are not GP's)

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  • Why would anyone want to ruin a family weekend over Easter for <£30 per hour after taxes to work for OOH.

    Reduce Demand not increase supply - but not a vote winner really, so no politician would dare tackle this problem.

    Mr Hunt already booked his slot for A&E over the weekend I assume?

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  • Bob Hodges

    Robbing Peter to pay Paul.

    The date of Easter has only been widely predictable since First Council of Nicaea in 325 AD.

    Did the DoH not get the memo?

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  • The prime minister mentioned GPs twice in the election debate. 8-8 mate. We will be falling over ourselves to burnout faster than we already are, see less of our family and meet more unreasonable wants NOT clinical needs of patients. If you're unwell come out of work and put your health first. Doctors have lives too.

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  • agree with 5.25 the rates being put into bids will destabilise not only OOH but day time GP too £100 an hour for sore throats and no paperwork, bring it on.

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  • Please stop encouraging parents with children suffering from coughs/colds and sore throats coming to GPs/OOH/AE and clogging up the whole system - by giving them antibiotics when they clearly have viral infections.

    It just creates a culture of I must see a DR every time my child has a temperature as they always get chest infection/tonsillitis.

    Less of nursery rung me 30mins ago to say little XXX has a fever and I must go straight to GP. Not seen her or given anything as I came straight here as she always needs antibiotics.

    Self care for simple viral infections, and of course seeing those who actually are sick despite home care.

    All of a sudden free appointments for everyone else who actually needs them. No extra opening needed.

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  • Dear 0814,
    Er..... the organisations mentioned above are all Social enterprises and thus, although they need to make a profit, all such profits are ploughed back into the service and do not go to shareholders.
    As for GMS practices...................

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  • I didn't open on Saturday but my neighbour did. 11000 patient practice. They saw 3. Great use of public money, well done NHSE! If I ever fancy going to a piss-up in a brewery I won't be asking you to arrange it.

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