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Independents' Day

New GP contract to include seven-day access requirement, PM announces

Seven-day access will form part of a new voluntary GP contract to be published by the Government, the Prime Minister has announced.

Speaking on the BBC’s Andrew Marr show today, David Cameron announced that the Government ‘will be publishing a new GP contract to get rid of the box-ticking and the form filling’.

Instead, he said, it will focus on ‘making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm’.

The contract will be voluntary and offered to practices or federations covering at least 30,000 patients. 

The BMA has said that this has not been discussed with them, 

NHS England chief executive Simon Stevens also issued a statement saying that they are developing a new voluntary contract for practices to expand and provide primary and secondary care by April 2017.

Mr Cameron told Andrew Marr: ‘I can announce today that we will be publishing a new GP contract to get rid of the box-ticking and the form filling.

‘I don’t think anyone is happy with the GP contract, so this new contract will focus on making sure that people in our country can get access to a GP on seven day a week basis, 8am to 8pm, that’s what we want to see.’

He added: ‘Already because of the steps we have taken, a third of people are accessing the NHS on that basis by next year, but we want it for everybody and that new GP contract will help deliver that.’

A DH press statement said: ’The new contract will be voluntary, with federations or practices that cover populations of at least 30,000 patients.

It added: ’The new contract will be offered to GPs on a phased basis, starting with those groups of GPs that are most ready to work in this new way and building on the success of the pioneering Prime Minister’s Challenge Fund for GP access and the NHS vanguards.’

GPC chair Dr Chaand Nagpaul said that the announcement was ’not discussed with the BMA’, and does ’nothing to address the root causes of the pressures on general practice’. 

He referenced Pulse’s investigation last week showing that due to poor uptake of seven-day services, eight of the original 18 ‘Challenge Fund’ pilots have reducing their opening hours.

He said: ’The Government must learn from its own pilot schemes where there have been a number of examples of weekend appointments having little or no pick up by patients. These proposals could waste precious NHS resources and divert staff and funds from overstretched core GP services.

’While getting rid of the box ticking of QOF is something the BMA has long been calling for, this should apply to all practices. It would be wholly wrong if this is being used as a carrot to only benefit patients for those practices considering the new GP contract.

’Crucially, we do not need the diversion of a new contract, we need proper levels of investment in GP services, and thousands more GPs and staff to keep up with the sheer number of patients coming through the door in order to provide safe, quality care.’

The announcement comes a Pulse investigation last week showing that due to poor uptake of seven-day services, eight of the original 18 ‘Challenge Fund’ pilots have reducing their opening hours.

At the same time, Mr Stevens announced that a new ‘voluntary’ GP contract will be developed to enable practices to work in bigger groupings and follow the lead of some of the ‘vanguard’ projects around the country that are piloting providing a wider range of secondary care and community services.

He said: ‘Many family doctors are now… wanting to pool their sovereignty and work in federations, super practices and our new vanguard care models.

’To support that, they are asking NHS England for a new contract option, which will combine core general practice with wider primary community and health services, serving larger populations.

‘So NHS England will now work with GPs – through the vanguard programme and beyond – to develop a new voluntary contract by April 2017.’

NHS England said in July that GPs would be offered ‘simple and attractive’ conditions to encourage them away from the national contract and join the ‘new models of care’ that are being tested across the country.




Readers' comments (45)

  • I realise you can only have negative comments on Pulse but I think it is worth waiting for the detail. If the 7 day access can be delivered across a large population and if there is new money(which I have heard there will be) it may well be attractive.

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  • classic.

    wait until practices are up and running with this service, then impose it as a mandatory part of the contract, removing any extra funding that goes to run the things.

    Like we haven;'t seen this before!!

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  • I've had a revelation - it's not about the money or the contract.

    This job is a vocation.

    Forget the contract.

    Make sure all patients have your home telephone number and let's all go back on call 24 hours 7 days a week. You could even get the wife to answer the calls.

    Patients will realise our self-sacrifice - thus no inappropriate visit requests would be made.

    Watch episodes of Doc Martin / Doctors for CPD.

    Everyone happy.

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  • Peter Swinyard

    The devil, as ever, is in the detail. Since we are now getting used to Government By Announcement I regret that it sounds as though the GPC has not been consulted yet. It wasn't about the PM Challenge Fund which was also a TOry conference announcement.
    Worse is to hear Jeremy Hunt say that he BELIEVES that 7 day working is good and that we will come to agree with him sometime. Ignoring the evidence of his own pilots. Ignoring the totally demoralised workforce (he has had a 30% pay rise, I have had a 25% pay cut. Gee, thanks).
    I am visiting a friend who was a single handed GP in Southport in 2 weeks. In Brisbane. He is so much happier there and able to practice the expert general practice at which he is so good.

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  • I am totally convinced that this government wants to destroy the existing nature of general practice - death by a thousand cuts. But I simply do not believe that the target is to sell off primary care to the private sector, but to rework the system so that it is easier for them to control, without the cost and bother of buying out all practices beforehand.
    The Achilles heel of this plan is that it is likely to be like the OOH debacle of 2004, which must have seemed a very good idea to managers at the time: 'get those inefficient, lazy GPs out of OOH, reorganise it well for them, and we will have a more modern and efficient service'. Then they discovered that it wasn't possible to organise it for the money on offer, the GP on-call was amazingly efficient and cheap, and that the standards often dropped under the new system.
    Exactly the same is likely to happen with the destruction of the current GP system. The government simply has no idea about how efficient most GP practices are. It will only find out when it has destroyed us - but by then, like OOH, it will be far too late and there will be no going back.

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  • This is what conservative’s want. Sad and unhappy GP practices. They are trying to push the GP’s to such a critical limit. When the hardworking, altruistic GP’s give up private care providers and corporate sharks will take their place. Well done Conservative’s.

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  • A new contract which is voluntary ... a contradiction in terms.

    A contract is an agreement by which you have to abide.

    Voluntary means you only do it if you want to.

    Any offer from this government means if we say you will do, you will!

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  • Anonymous | Work for health provider05 Oct 2015 9:40am

    Not sure if you've heard but there are no new money in NHS. The government wishes to save 22 Billion (30-8 billion of so called promised investment) over the next 5 years. Given the proportion of money spent on primary care in NHS has actually decreased in the last (mainly conservative) government, I doubt we will see any "new money". At best it's recycle from efficiency saving but given the cuts required, more likely a cut (rather then saving) which funds this.

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  • This translates to:
    Voluntary contract = will maintain current (falling) level of income
    Refusing to do above = much worse non viable contract imposed

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  • Voluntary contract means DES, if practices don't sign up,CCG has to, meaning GPs by default.
    Less paperwork in new contract means UPA DES and some QOF stopped, the monies put into new DES.
    IF you want to earn the money must sign up to the DES, uhm!
    New living wage, less income = redundancies and surgeries close

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  • Is anybody stupid enough to believe there is somehow more money or better conditions in the NHS for anybody? let alone primary care. I hear arguments from some partners that 'oh well it's peaks and troughs, and we are in a trough, so it must go up soon'...well really? REALLY? are people really that thick to think you'll suddenly get more money?

    yes it happened in 2004, and look what happened - DOH are clawing back every penny they can. this won't happen again. a) there's no money to increase funding, b) they aren't thick enough to underestimate GP effectiveness again, c) they don't WANT to give you any more money, d) they want to horde it all / siphon it off.

    get real people, there is no money. there is only more work, for less funding. more expectations, more demand, less leway, less acceptance, less respect.

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  • I still can't understand why do many GP feel that they have to save NHS. If politicians are not bothered why should we? Why do we let ourselves dragged in to this. This government is hell bent on destroying free NHS because this country simply cannot afford it. All they are trying to do is pushing ourselves against the wall so that when we all resign they can say that look GP have left NHS. GPs are to be blamed for death of NHS. We should not get fooled. Best way forward will be to hurt government where it hurts most, ie . Refuse to accept extra work. refuse to sign new contract. No CCG will be able to balance books without cutting services. And CCG should clearly advertise that services are being cut to cut in budgets as dictated by Government. Advice patients to contact their MP for every small query/problems.

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  • Ivan Benett

    "Anonymous | GP registrar04 Oct 2015 4:42pm Just waiting for our well known pioneer to pipe up and give his full support to Cameron's supermarket style expansion of the free 'eat all you can' Buffett approach to General Practice." Who IS your trainer and course organiser? He should be ashamed of himself (or she/herself)
    Maybe you're the same brave anonymous registrar as 9.50pm last night. Actually, I was in London preparing to present our project to the HSJ for a prize on the Manchester Care Record. Look out for it. It's ground breaking. So yes I suppose I was working.
    Yes I think the principle of seven day access to full Primary Care is one that has to be supported. It's what people want, and it's what will make the NHS sustainable and safe for our patients, but it comes at a price.
    We need to make General Practice, and other Primary Care roles more attractive to young clinicians because it can't be done without it. We need to change the whole way we work with each other as practices, but also with community and secondary care, as well as social care services. This will take new investment. Of course it will.
    We're doing this in Manchester, come and see. All you brave anonymous cynics, do please email me None of you has done yet. Not one single one! Especially that registrar or his (or her) trainer, if he's not brave enough.
    Do I support Tory policies? - no not usually - google me if you doubt it - but on this they have it right, and I don't mind standing up and saying so, rather than skulking away in anonymous shadows. As the other Jeremy says. Lets have a debate.

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  • Animal Farm is an allegorical and dystopian novella by George Orwell, first published in England on 17 August 1945. According to Orwell, the book reflects events leading up to the Russian Revolution of 1917 and then on into the Stalin era in the Soviet Union.[1] Orwell, a democratic socialist,[2] was a critic of Joseph Stalin and hostile to Moscow-directed Stalinism, an attitude that was critically shaped by his experiences during the Spanish Civil War.[3] The Soviet Union, he believed, had become a brutal dictatorship, built upon a cult of personality and enforced by a reign of terror. In a letter to Yvonne Davet, Orwell described Animal Farm as a satirical tale against Stalin ("un conte satirique contre Staline"),[4] and in his essay "Why I Write" (1946), he wrote that Animal Farm was the first book in which he had tried, with full consciousness of what he was doing, "to fuse political purpose and artistic purpose into one whole".

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  • Ivan - I have no idea why you presume to know the minds of trainees and newly qualified GPs. What makes you think they welcome your consumerist ethos? Their response to the Tory decimation of primary care? Many of them are planning to go abroad. We are facing one of the worst recruitment crisis in history and your answer is to open 7 days a week?

    We are not a commercial organisation yet. We don't have anyone else to compete with. We are a monopoly provider. Basic business and economical sense will tell you that in this situation, the most efficient way of providing a routine service is to do it in the least number of hours. The only reason why Tesco open all hours is because they are competing with Sainsburys and Waitrose. We are a socialised healthcare system which is the most efficient in the world if it were properly funded.

    But you just keep receiving your prizes and awards from the Tories and keep massaging your ego. Whilst the rest of us burn.....

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  • Ivan- as you say it comes at a price. What do we do if the government are not to pay that price? We can see that they don't want to pay the junior doctors an enhanced rate for working unsociable hours, but that is what our staff will expect, as , indeed, we will. Where lies the default if a slot can't be filled or someone goes off sick at short notice? With the partners who may have already worked a 60 hr week? Even if, in the very unlikely event of it being funded properly, can we trust the government to maintain that level of funding? Or are so many practices going to be involved in this that it is like an OOH cooperative in which case it would be better to fund an OOH provider to offer routine appointments ?

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  • Vinci Ho

    Remember this from O'Brien:

    You are a slow learner, Winston."
    "How can I help it? How can I help but see what is in front of my eyes? Two and two are four."
    "Sometimes, Winston. Sometimes they are five. Sometimes they are three. Sometimes they are all of them at once. You must try harder. It is not easy to become sane.
    If you love Animal Farm , 1984 is a must read .

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  • Ivan is absolutely right. The future I'd do bright with NHS, we are seeing less immigrating juniors, seniors are hanging into their posts and refusing to retire, hardly any partnership our salaried posts are coming up and the job satisfaction is the highest its ever been. Every federation and CCG meeting has a buzz about these longer opening and everyone just can't wait. I've not heard anyone mention cost efficiency, burning out, lots of sociable hours or staff retention problems with weekend & 8-8 opening.

    In fact, its so good I've not prepared any letter of resignation sitting in my drawer if this is enforced. As Maureen said, its never been a better time to be a GP!

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  • Excellent news. I have plenty of staff and GP's to provide 7 day cover from 8-8 infact 24/7.GP's love the work life balance in UK. GP's are already applying jobs from Australia, Canada, Newzeland and UAE to work here. No shortage of nurses and allied health professional. Feeling luck to hear this news.

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  • You're wasting your breath responding to Ivan. GP Registrar I wouldn't take him seriously. This is what he actually cares about.

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