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GPs buried under trusts' workload dump

NHS managers begin talks to create routine GP Saturday opening in London

NHS chiefs in London have begun talks with CCG leaders about shifting funds into general practice in a bid to offer longer appointments, create a seven-day general practice service and change GP contactual arrangements in the capital.

The planned reorganisation – which was set out in a landmark report last year – was launched today by the NHS England London area team and will cost up to £810m a year over the next five years, which London NHS managers and CCG leaders say could come from other parts of the capital’s health budget.

It marks the first step towards implementing the ideas set out in last year’s report, with talks set to begin between the local area team and the CCGs in the capital.

The plans for general practice – the first of the 12 health programmes to go live – include:

  • routine opening from 8am-noon on Saturdays;
  • opening 8am to 8pm, seven days a week via a network of practices;
  • telephone triage system;
  • flexible appointment lengths;
  • add-on services such as citizen’s advice and probation services;
  • liaising with schools and workplaces to improve health literacy within their patient population;
  • outreach for patients not currently seeking healthcare
  • working to joint contracts with other GP practices, primary care, social care and hospital providers;
  • identifying all patients that need ‘coordinated care’ and manage their care through multidisciplinary teams.

A spokesperson for NHS England London told Pulse: ‘The proposals outlined the estimated cost of between £310 and £810m over the next five years, and the next steps are going to be to make that happen. If we can attract new investment that is great but the point is it can be done with what is there – we just need to shift the funds slightly.

‘Those conversations and all the actions needed among relevant people will now happen as a result of this framework being published.’

Dr Marc Rowland, chair of London CCGs and a GP in Lewisham, said: ‘Today marks a major milestone in our vision of transforming care for millions of Londoners. CCGs across London have come together and we are working closely with NHS England and other organisations to tackle a wide range of issues, including primary care, cancer treatment, mental health and services for the homeless.

‘London’s population is growing and changing and we need to keep looking ahead and working collaboratively to ensure we can meet the people’s needs and provide world class care all across the capital.’

Dr Michelle Drage, chief executive of Londonwide LMCs, said the reorganisation plans were ‘moving in the right direction’ but was sceptical as to whether the funding would be realised.

Dr Drage said: ‘Our view is that you can’t do any of that without the money up front – or at least confidence that there is going to be money. We want them to put their money where their mouth is – to support GPs to work collaboratively so that patients can receive the best of care with the resources we’ve got.’

She added: ‘If this moves us in that direction it’s got to be better than doing nothing, but it’s really down to people on the ground to move things on – you can’t just wave a magic transformation wand and hope they will deliver. And you definitely can’t if you haven’t got people on the ground who are fired up and motivated – and we certainly don’t have that, we’ve got a workforce crisis in London that means it’s really difficult.’


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Readers' comments (35)

  • Just Your Average Joe

    If all CCG and politically affiliated GPs are the first to do the OOH routine shifts on a semi permanent basis themselves, others may consider following.

    Otherwise it is like the esteemed generals sitting comfortable well behind enemy lines, telling the brave soldiers to walk slowly towards the enemy trenches - insisting its a great idea and you'll all be fine.

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  • naive fools. If London GPs start to go along with this, then in 2016 the only contract the CCG will offer practices is one that is 8-8 7 days per week and if a practice doesn't sign that contract they will be closed.

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  • I really hope that is the case as there will be very few local practices left. patients will have to travel long distances (even to Manchester and London) to see a GP then. Bring it on.

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  • Here we go ...

    'what about Sundays?'

    'people get sick 24 hrs a day and they ought to be able to see their GP'

    'cut their pay and make them work Saturdays'

    'Tesco's is open on the weekends why can't GPs work the weekend'

    etc etc

    the usual suspects will shake their heads and say 'we need funding', 'we need more staff' then they they will say 'we need to think about patients and yes patients will benefit' and if by magic it will be part of the contract and the majority of GPs will do it.

    Seriously why bother resisting ?

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  • Good God Vince Ho, Read what I said again! No money up front , no work done. No people to do it, no work done. If GPs on the ground don't do it, it won't be done. That was the message. By the way I'm chief exec not chair. And I was the GP trained in a certain practice in W6 the year befpre you! So there ;) . Michelle

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  • Harry Longman

    There is a small level of urgent and emergency demand for which weekend opening should cater. It's done with OOH. Routine opening would hurt access, because GPs will be spread from more popular times, and it will hurt GP morale. A stupid idea.

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  • Ivan Benett

    Well done London, don't listen to the gloom merchants. Whatever you did wouldn't be right for them. Of course you'll need to see the money, yes and the workforce, but once you get that you can fly. What Manchester does today, London does tomorrow. The guy (or gal) who wont work on Saturday mornings - fine don't. Someone will, and they'll be able to do something else on Monday. Go for it London. I only wish we had that sort of cash in Greater Manchester.

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  • Happy to work saturday for double time

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  • but im a locum and i get paid for what I do. as a partner I would be worried that over time it would be routine and earnings would be no better than now just working saturdays as well

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  • Vinci Ho

    Apology to Michelle. I actually wanted to simply say that LMC and CCG are talking completely different language on this . I totally agree to what you said . May be my English is still crap these days.

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