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GP-led health centres threaten OOH funding

By Steve Nowottny

NHS managers are beginning moves to renegotiate contracts for out-of-hours services because of a fall in demand since the launch of GP-led health centres.

An evaluation at one of the first of the centres in the country to open has found large numbers of patients are choosing to use it rather than the local out-of-hours provider.

Primary care academics are predicting that the value of out-of-hours contracts could fall sharply because of the heavy overlap with GP-led health centres in the early evening and particularly at weekends.

Managers at NHS Northamptonshire reported that patients seeking care at the weekends had been flocking to the walk-in facilities at the new Darzi centre.

The PCT reported a ‘marked decrease' in out-of-hours attendances in the town of Corby since the Lakeside Plus GP-led health centre opened in early December.

And it has wasted no time in trying to re-negotiate the levels of funding for out-of-hours care. The trust is currently tendering for a new out-of-hours provider and said it would be trying to drive down the cost of the contract.

Nicki Price, associate director, Primary Care Contracts and Market Development at NHS Northamptonshire, told Pulse: ‘We absolutely expect to see an impact in what we pay for the out-of-hours services as a result of the 8-8, because obviously there's activity shifting around the system.

‘Some of the figures have shot up, because the walk-in centre's taken off and people are talking about it. So instead of contacting the out-of-hours service they're just coming down to the walk-in instead.'

Professor Chris Ham, professor of health policy and management at the University of Birmingham, said he believed other out-of-hours providers would face similar pressures:

‘I predict two scenarios. For some patients who are not currently able to access services, these will be additional and generate more demand.

‘For other patients, it will be a diversion from services that they otherwise would have used, such as their own GP practice, out of hours and A&E taking pressure of hospitals for cases that are more appropriately dealt with by these GP services.

Walk-in numbers at the Northamptonshire centre have been far higher than expected, with a total of 1,201 patients in March compared with an estimate of just under 700.

But Ms Price said the centre had only registered around 250 patients by the end of March – compared with a projected 500 - partly because a local house-building programme had stalled due to the recession.

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