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GPs hit with breach of contract notices after NHS England checks up on practices closing early over Christmas

NHS England has issued breach of contract notices to 12 GP practices in London for closing early on Christmas Eve and is preparing more notices for those who were closed on New Year’s Eve, Pulse has learnt.

NHS England’s local area team in London said that staff rang round 238 GP practices in the capital after 3.30pm on Christmas Eve to check they remained open. As a result of the calls, NHS England found that 12 practices had transferred calls to an alternative provider and has subsequently issued them with a breach of contract notice.

It repeated the same exercise on New Year’s Eve and told Pulse that further breach notices ‘have been or are in the process of being issued’.

Londonwide LMCs said it had initially reached an agreement with local managers to allow GPs to close early on Christmas Eve but that this offer was withdrawn by NHS England in London after national primary care chief Dr David Geddes sent a strongly-worded letter informing practices across the country that remaining open during core hours would be ‘non-negotiable’.

A spokesperson for NHS England (London) told Pulse today: ‘From 15.30 on Christmas Eve we called 238 practices in London. 12 practices were found to be closed and were issued with a breach of contract notice before New Year’s Eve.

‘On New Year’s Eve we repeated the process and further breach notices have been or are in the process of being issued.

‘We undertook this exercise as we wanted to ensure that patients in London had access to the primary care services they are entitled to and that GP practices had signed up to deliver.’

At the time of writing, NHS England was unable to confirm whether this exercise had been repeated in other areas of the country.

But in a statement, Londonwide LMCs said they were clear that the practices had not breached their contract by transferring calls to another provider and it would be supporting practices if they wanted to challenge the notices issued to them from NHS England.

The statement said: ‘The GMS contract is non-specific on hours of opening on Christmas Eve and requires only “reasonable access to services”. It is the firm opinion of Londonwide LMCs, the GPC and BMA Law that the GMS contract does not require that practices are physically open during all of core hours. This was made clear in guidance issued by the GPC and Londonwide LMCs.

‘Last year one of the PCT clusters objected to this but LMC negotiated a reasonable response. A similar compromise was negotiated with NHS England (London) early in December but following a letter from Dr David Geddes this agreement was withdrawn and practices were told they were expected to remain open until 6.30pm Christmas Eve.’

‘Londonwide LMCs are contacting affected practices and offering support and guidance if they wish to dispute the breach notices issued by NHS England (London) and we are liaising with the GPC to ensure their resources are adequately mobilised. Because this is a national issue, Londonwide LMCs will be working with other LMC leads across England.’

‘It is Londonwide LMCs’ view that NHS England (London) have wasted valuable resources in contacting so many practices and [we] view their action as mean-spirited and vindictive with no benefit to patient services.’

Before Christmas Pulse revealed many GPs were planning to defy NHS England’s guidance on early closure over the holiday, supported by guidance from the GPC and LMCs.

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Readers' comments (44)

  • Peter Swinyard

    What a complete farce. Number of calls after 3.30pm on Xmas eve is always vanishingly small (I took NO calls in this period this season as I was on call for my own practice). Did anyone else try to ring Dr David Geddes at 4pm on Christmas Eve at NHS England HQ where it was one of his regular working days?

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  • What hypocrisy! Before criticising practices for alleged minor infringements of their contracts, NHS England might like to reflect on the fact that it doesn't seem to be able to arrange for practices to be paid on time (in defiance of the government's promise to pay small businesses within 28 days). Some of this money is, I understand, 6 months overdue and practices have been threatened with bailiffs as a result of the cashflow problems this has created.
    My suggestion to NHS England is simple - put your own house in order before you dare to criticise anyone else.

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  • Vinci Ho

    Editor ,
    Are you able to obtain a copy of these letters (breach of contract notice)? Anonymise the practice name and post it on this platform !

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  • , GPC promised robust support for anyone fulfilling the contract and subject to action.
    Good luck Chand, , its make or break for both parties facing off and I hope you make it.

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  • Has NHS England nothing better to do than ring around 237 practices; this is fiddling while Rome burns. We were open until 6.30pm with four doctors on duty and we received only one call after 3.00pm, plus two drop ins to pick up previously ordered prescriptions; thereby saving the NHS from multiple A&E attendances – not!

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  • Well they did say they were going to do it! We were open as usual to 6.30 - dead as a dodo - New Year's Eve much the same!

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  • If the BMA fail to fully back and win this then there is no point in remaining as members.

    If though as I expect the BMA case to be upheld then Dr Geddes position is in my view fatally undermined.

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  • I assume NHSE will have to prove inadequate cover was provided as per our contract. Unless these practices were silly enough not to arrange an alternative cover, this is impossible to prove (unless they can identify patients who actually came to harm).

    So I wouldn't worry about it though personally I think they should have just kept the practice open with minimum staff in order to save themselves the unnecessary trouble.

    P.s. I did actually referred a patient to 2ww clinic and admitted another on Xmas eve, injected a knee and did a few private medicals on new years eve so it wasn't a complete waste for me!

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  • NHS England closed at 5pm instead of their published closing time of 6pm (Mon-Fri excluding Bank holidays) on both Christmas and New Year's Eve

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  • Sorry, but I have no sympathy for those practices who did not stay open. 1) they were warned 2) they quite happily put the work onto someone else, possibly casualty 3) they fed the media that is anti GP and damaged all our reputations.

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  • However, while having no sympathy for practices that did not stay open, can we please have a statement from NHS England that all it's senior staff were at there desks at 4.55 on Christmas Eve unless taking leave. Suggest Pulse do a ring around survey or email all the top staff to find out if they were at their desks, or on official leave.

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  • Dr Mustapha Tahir

    This is absolutely pathetic! NHS England, this action will back fire on you. The public will consider your actions as a total waste of time and resources. Get real!!

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  • What a waste of time and resources. Practices will know their local needs and respond accordingly. Typical London centred approach having no logical or rational appreciation of requirements for local service. Perhaps it would be more rational to get rid of the NHS exec and allow services to be provided by local services.

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  • I'm afraid that as a non-GP (ie as a patient and tax payer), the assumption of some GPs that it's OK to shut up shop when they feel like it is unacceptable. So many of these comments come over as the arrogant outpourings of people who have forgotten why they came into medicine in the first place. Many GPs did work as very reasonably requested by NHS England. They are to be praised for understanding their professional obligations.

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  • I contacted NHS England staff two days before Christmas and were told they were closed until 7th January!

    Don't do as they do, do as they say!

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  • A complete farce- I agree
    But the question remains..... why is the BMA GPC advising Practices they can safely close if this is in fact not the case? We have to have confidence that our union is giving the correct information-If not and these breaches are upheld- then I agree that membership of the BMA seems pointless

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  • Anon@5.06pm - why 4.55? NHS England supposed to be open until 6pm according to website. Wonder what their contract states.

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  • It does not matter, in some respects, what NHS England or X or Y do. That is for them. We are contracted to provide a level of care. Did we do this on Christmas and New Year's eve? If we did, then that is the end of the matter. We must do our duty so that no patient comes to harm. I do not think that we have a case to answer provided we did that.

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  • Non-GP (why are you posting on this site?) anon @6.23pm - the point is that patients do not make routine appointments at these times having other things to do themselves. I might have been sitting at my desk but with no patients so the result was a couple of hours lost that I and my reception staff could have spent with family. I already work 10-11 hour days routinely and I don't think that any inference could be made regarding the understanding of "professional obligations" from finishing a couple of hours early on one or two days in a year. Some perspective, please.

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  • I wonder if those GPs who did close early went out to do some last minute shopping. If so, I bet they would have been very annoyed if their favourite shop/pharmacist/barber/public transport had decided to close at 15:30.

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  • I close my practice every Thursday afternoon. I have done for the past 23 years. And so do most of the practices in my city. We sometimes use this time for educational meetings, mandatory training, staff meetings. We employ the deputising service to cover. I do not remember a single patient complaint, as they are largely aware that this is the service we provide. Presumably I have been in breach of contract for nearly a quarter of a century.

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  • Why did NHSE target only London practices?
    There is a national contract and the same rules should apply across the country.
    It often feels like GPs in London are being specifically singled out.

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  • I see the usual ignorant comments are back, from people who don't understand our contracts.

    If there is no demand, there is no reason to stay open. Anyone who doesn't understand this should not be posting here. Maybe the 'taxpayer' should spend some time reading the GMS contract before posing as a health professional.

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  • Russell Thorpe

    I covered reception myself (non of my staff were willing to work) on both Xmas Eve and NY Eve I had a phone call at 2.20pm. Xmas Eve said wrong number NYE just hung up. Im in Lancashire.

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  • from my understanding the funding to open hours was removed as it was a Qof indicator.
    So given that the opening hours money was removed I fail to see how even breach notices could be served . Some lawyers are going to get very rich on nhs money, especially as most contract have reasonable wording in it , so I wonder what the test of reasonability is going to be.
    From my experience the few pt that attended only came to give boxes of chocolates and to say thank you.

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  • A contract is an agreement between two parties . A contract cannot be altered unilaterally . The government has changed our terms of service without agreement on three occasions . If they can alter this document unilaterally it cannot constitute a contract therefore there is no contract to breach .

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  • I suspect "anonymous" patient and taxpayer [ as indeed we all are] is an employee of NHS England - may even be Jeremy Hunt for all I know. Time these anonymous cowards owned up! We are constantly expected to soak up more and more work. The population and their demands are ever increasing. Does NHS England or their political masters ever provide appreciation or encouragement? NO - just the usual petty vindictiveness. Time they all went on a CPD course on how to manage their workforce.

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  • David - What "more work" was being "soaked up"? By having one GP and one receptionist on site, this fulfilled the contract. All the other staff can go early. Same on New Years Eve so 4 people worked their proper hours and a dozen or so (20+ in a large surgery) had time off. 100 Hour pharmacists were also meant to stay open until 11pm (or whenever their contract hours were). Wonder how many of them managed to close their doors early.

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  • It is a farce and an absolute shame the stance NHS England has taken. Being paranoid i believe that this is a contrived tactic by NHS England to paint as bad a picture it can about Primary Care so they can introduce a more radical plan on access... wait for it...

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  • David - What "more work" was being "soaked up"
    ----

    I suspect he was referred to the ongoing massive shift of unfunded work from secondary into primary care.

    By the way it doesn't matter how many GPs and receptionists were present since no patients wanted to be seen anyway.

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  • NHSE shut up shop an hour early on both Christmas Eve and New Year''s Eve. I wonder why given these are normal working days, according to them. I did not opt out of 24 hour care and therefore could shut early. Even so, I hung around until 5.30pm with no customers from 2 onwards. The government can change the contract unilaterally - that was in the 2004 contract which I refused to sign because of this clause - but was then forced to sign or face closure on 01.04.04.

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  • Not a farce at all, but a carefully orchestrated campaign of GP villification. GP's are now the whipping boys for all that isnt working in the NHS. Read the Telegraph if in doubt, especially the comments in the discussion forums, where GPs are (amongs other attributes): Overpaid, incompetent, dishonest, work shy, pig ignorant, etc etc. FGS wake up and smell the coffee..... the profession (GP mainly) is facing an unprecedented diatribe of abuse, scapegoats for all that is wrong in the NHS.

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  • Dr Mustapha Tahir

    This topic generated so much comments. Yet, more than 75% are made anonymously. Why are so many GPs afraid of contributing to debate, as important as this, openly? Any wonder whistleblowing is very rare in General Practice?

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  • So dr Geddes, where were you on Christmas Eve and New Year's Eve?

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  • David - What "more work" was being "soaked up"
    ----

    I suspect he was referred to the ongoing massive shift of unfunded work from secondary into primary care.
    --------------

    As a consultant that worked (and yes I do mean worked) on Christmas Day and New Years Eve (until 1in the morning) I can assure you that there is no shortage of work in hospitals either. There is no doubt that the amount of clinical work and demand is growing at a rapid rate.

    As for government agencies living up to their own standards I remember trying to speak to someone at Monitor before Christmas last year at 3pm to be told by their switchboard they'd all had the afternoon off for a pi$$ up Christmas Party. From the coal face of a hard pressed (and alcohol free) hospital this struck me as taking the Michael at least!

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  • Mike Henley - are you limited to 48 per week as per EWTD? We are not. I routinely work a 60-70 hour week and this is not counting doing my own patient palliative care for nothing out of hours. I also tried to contact surgical secretarial staff at my local hospital at 2.16pm Christmas Eve to find they had all fecked off early. I agree entirely that our hospital colleagues work very hard in the face of ever increasing demands but I do believe that GPs work bloody hard at way over the standard 48 hour week most NHS staff face (35 hours per week if a nurse). It is not a competition - but is very demoralising when GPs are blamed unfairly for everything. How about politicians who stoke up unreasonable demand where there is not the workforce to manage this?

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  • Time to go private?

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  • We were open until 6.30 xmas eve and new years eve as usual and the only pts we saw were from a local dentist who apparently was closed for dental treatment from 16th Dec until 3rd Jan, if pts were in pain they would provide scripts at 10am every morning but could offer no actual treatment!....maybe we should'nt be the only ones under such intense scrutiny....

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  • Doi I'm a scottish GP but this does seem to make mockery of " Independant Status"
    We seem to independently agree to jump as high as HMG wants

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  • We have in previous years arranged for the ooh service to take over on Xmas & New Years eve so that we could close at 4pm. threatened with a snotty letter this year we decided that we had neither the time, money or enthusiasm to fight a breach of contract notice with NHS England (with LMC backing or not). We stayed open until 6pm on both days and over the full period from 4pm we had one person in the surgery and 2 phone calls. Complete waste of time and energy. I would like to know what the difference is if a practice closes for half day training every week (some do) as opposed to closing early at Xmas once a year? If there is a difference then I can see that we will be arranging our "team building" sessions for the afternoons of 24th & 31st Dec 2014!

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  • Most GPs did stay open (ourselves included) despite the fact that it was quiet. It really does the profession no service to defend those practices that were caught out sneaking off for an early dart. It is true - they were paid to be available, and they should have been so. The fact that NHS England are behind in paying some practices is entirely beside the point. 2 wrongs don't make a right, people!

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  • Smithdown Road Paediatric Walk In Centre , Liverpool with a contract to supply Children's walk in services on all bank holidays was permitted to close by NHS England because "only 5 children attended in the wholes 12 hours last Christmas Day" and the contract says be open, not provide necessary service I.e. telephone on premise doors closed.
    is this evidence of deliberate differential treatment of gP's?

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  • NHS England was not available in the few days leading up to Christmas, I tried hard to contact them and were told they were closed until after the holiday … one rule fro them and one for GP's!

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  • NHS england..yet again confirming they are not fit for purpose..i suspect they could learn a lot from the Scots body where common sense is more likely to trump mindless misguided ideologically based maladministration as 'nhs england'
    PS this is a fine example of 'no top down admin from the new nhs'...!

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