GPs must extend hours, not just swap them
By Gareth Iacobucci
GPs must genuinely extend opening hours under new Government reforms, rather than simply working more flexibly, the NHS head of commissioning has warned.
The comments dash hopes GPs might be able to substitute extra hours for time off earlier in the working day, and raise the prospect of a substantial increase in practice workload.
Speaking to delegates at the National Association of Primary Care conference last week, Mark Britnell, NHS director general for commissioning and system management, warned GPs that a failure to open longer could leave practices under threat from alternative providers.
‘We're not expecting you to substitute hours, we're expect-ing you to add hours,' he said.
‘Where GP practices don't want to stay open longer, we'll invite other people who will,' he added.
The escalating pressure on opening hours follows Lord Ara Darzi's interim report on the NHS published earlier this month, which said it wanted half of all GP practices to open evenings or weekends within the next three years.
Mr Britnell insisted proposals for extended hours were ‘not revolutionary', and told delegates: ‘The best of you will want to do it.'
But he said it was vital ‘increased flexibility' was brought about by locally commissioned services, and called on PCTs to ‘step up to the plate'.
His remarks come as PCTs ramp up the pressure on GPs ahead of January's patient survey, with some practices being given only three months to extend practice opening hours and improve access.
Sheffield PCT has demanded detailed action plans on access from all practices, and aims ‘to achieve measurable improvements over the next three months'.
Hillingdon PCT, which has appointed a dedicated ‘access facilitator', has set a November deadline for reviewing opening hours.
GPs also face a postcode lottery over whether they will receive additional funding for improving access.
Some PCTs, such as Sunderland and Heywood, Middleton and Rochdale, are looking at providing extra funds.
But other trusts, such as East Riding of Yorkshire, have even suggested that GPs could offer the services for free in order to improve patients' experience.
Dr Trefor Roscoe, GPC member and a GP in Sheffield, said it was ‘absolutely ridiculous' to expect GPs to do more work without more funding.
‘Has the chief executive of that PCT foregone his bonus for the past three years in order to improve the patient
‘I think not.'
firstname.lastname@example.orgDr Trefor Roscoe: ridiculous to expect more work for no more money Dr Trefor Roscoe: ridiculous to expect more work for no more money