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GPs express fears over out-of-hours funding

By Gareth Iacobucci

Exclusive: Only one in seven GPs believe they will be given sufficient funds to be able to commission out-of-hours care safely, a Pulse survey has found.



The Government's overhaul of the NHS will see GP consortiums assuming full responsibility for commissioning out-of-hours services in England from April 2013, under much tougher regulation than has been the case for PCTs.

But GPs responding to Pulse's survey have expressed serious concerns that consortiums will not be given adequate funding to commission services safely, due to the huge financial pressures facing the NHS.

Of 410 GPs surveyed, two thirds said they were not confident they would be handed sufficient funds to commission out-of-hours safely, with just 14% believing they would be given adequate financial backing.

The fears come after the Government's primary care tsar Dr David Colin-Thome told Pulse last week that the sum GPs gave up in return for the opting out of out-of-hours provision in 2004 would not be reimbursed under the revamp, but that the money will remain part of the overall funds available to support commissioning of out-of-hours services.

The Government announced last week that GP commissioners would have to meet rigorous new standards for OOH care after some high-profile failures in services commissioned by PCTs.

The survey also showed that only one in eight GPs will choose to provide out-of-hours themselves when the changes come into force, despite health secretary Andrew Lansley's recent forecast that many GPs would choose to provide when they assumed commissioning responsbility.

On average, GPs responding to Pulse's survey felt £15,000 per head should be factored into commissioning budgets for out-of-hours, although over a quarter of GPs said more than £20,000 of funding per head would be required.

But despite their widespread anxiety over funding and aversion to providing the service, GPs did express support for the motion narrowly voted for at the annual LMCs conference for the profession to take a ‘central role' in commissioning out-of-hours, with 54% backing the call, compared to 38% who opposed it.

Dr David Bevan, a GP in Wisbech, Cambridgeshire, was one of many GPs anxious about the financial support they would receive to ensure high standards in out-of-hours care.

He said: ‘It was PCTs' inexperience and cost cutting that made their responsibility for out-of-hours a disaster. GP consortia will be handed inadequate budgets and enhanced expectations to sweep up after PCT incompetence.'

Dr Judith Davis, a GP in Over, Cambridgeshire, said she was in favour of GPs commissioning out-of-hours, but expressed doubts that ample funds would be forthcoming.

Dr Davis urged the Government to: ‘Give out-of-hours back to local GPs, but fund adequately and allow every practice to be part of a coop.'

A Department of Health spokesperson said: 'Out of hours care needs urgent reform and GPs are best placed to ensure patients get the care they need, when they need it.

'The Government is committed to putting GPs in charge of commissioning local health services including out of hours services, which will be commissioned as an integral part of a high quality 24/7 urgent care system and we will discuss our proposals with GP organisations.

'Our proposals are not intended to force GPs to take on responsibility for providing out of hours services themselves but, as the Pulse survey results themselves show, more GPs are considering providing the service themselves than are currently opted in.'

GPs express fears over out-of-hours funding Click here to catch up on the latest developments to come from the health White Paper.

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