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Independents' Day

GPs threatened with breach of contract notices for closing early over Christmas break

Exclusive Practices across the country have been threatened with breach of contract notices if they fail to open from 8am to 6.30pm on Christmas Eve and New Year’s Eve, Pulse can reveal.

NHS England has told local area teams that Christmas Eve and New Year’s Eve must be treated just like any other day, leading to some local area teams sending letters to GPs warning that any attempts by practices to outsource work to out-of-hours providers will result in breach of contract notices.

The warning comes despite LMCs seeking legal advice and insisting that early closing is permitted by GP contract regulations.

An email obtained by Pulse from Amanda Alamanos, primary care lead for Shropshire and Staffordshire local area team, warns that practices must not sub-contract services.

It says: ‘The area team stance is that practices should remain open their normal opening hours on Christmas and New Year’s Eve and does not agree to any practice subcontracting their responsibilities to another provider.’

‘In line with that, and as conveyed to LMCs, if practices do not open their normal opening hours on these days it will be considered a breach of contract and the relevant notice will be issued against the practice.’

Similar letters have been sent out by local area teams in Birmingham and London.

A spokesperson for NHS England said: ‘NHS England recognises the need for patients to access high-quality primary care services in a timely way.’

‘In support of this, and to ensure a more consistent approach to opening hours, primary care services are required to meet their contractual obligations. This includes opening normal hours on Christmas Eve and New Year’s Eve, which are working days.’

However, GP leaders argued that demand from patients is traditionally less on those two days, and insisted the contract does not necessitate practices remaining open throughout core hours.

Dr Robert Morley, chair of the GPC contracts and regulation subcommittee and executive secretary of Birmingham LMC, said the issue was being discussed at a GPC level.

He said: ‘For [local area teams] to refuse to subcontract, they have to give a valid reason. That would have to be on the basis of practices not meeting the reasonable needs of their patients. There is no way the area team could evidence that on traditionally quiet afternoons when a service provided by a good out-of-hours provider will be perfectly safe and adequate.’

Dr Tony Grewal, medical director of Londonwide LMCs, said: ‘As long as practices ensure that they have contracted with an out-of-hours or some other service so they have a fall back, there is no reason why they should not give due notice to the contracting authority and close early.’

‘We have taken that to BMA lawyers and they agree with our understanding,’ he added. ‘We have contacted all our practices to let them know this is the case and we will support practices to the very limit, even taking it to the first-tier tribunal of the Family Health Services Appeal Unit if any practices are issued with breach notices or worse.’

Dr Grewal added that working full hours on these days was a ‘waste of everyone’s time’. He said: ‘We have all done those shifts where for some reason or another we couldn’t use out-of-hours providers in hours and some poor so-and-so sits there in the waiting room reading 20-year-old copies of Woman’s Own and absolutely nothing happens. No-one comes, no-one rings, it is absolutely dead.’

Readers' comments (25)

  • "This includes opening normal hours on Christmas Eve and New Year’s Eve, which are working days"

    Has anyone ever tried to phone the PCT on a Christmas Eve afternoon? Oddly there is no-one there to pick up....

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  • We tend to have an open surgery on these days and if quiet (and it usually is) one GP and a receptionist sits at the surgery. Other GPs can be called to come back to surgery if it got busy but that's never happened before.

    Surely this is a reasonable stance - we are still open but we've decreased the staffing according to demand

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  • I took VER this year and one of the reasons was when the local PCC as it was then issued breach of contract notices after that farcical day of action in June 2012.

    It made me so angry when I Thought of all those thousands of times in the past where I worked way way beyond the call of duty being on call on 1 in 1 Rita's to cover holidays, on call all weekend day and night, saw patients at 3am then was there for more at 8am until 8pm the list goes on and on.

    People and politicians have no idea whatsoever of the commitment of GPs and the work put in 'free of contractual constraint'

    Well I don't care now, I've escaped. In all of mt time as a GP looking after many many patients approaching the end of life I never heard one of them say 'you know what doc I really regret having retired too soon, I really should have worked as long as possible'

    Well patients always give you the answer if you listen to them so I did!

    Get out if you can

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  • I suggest that on christmas eve and new years eve one GP from each area try contacting their AT at 5pm and see what the success rate is accross the country,

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  • Peter Swinyard

    Completely agree with Anonymous | 29 October 2013 9:28am - we should, in areas where bureaucrats try to micromanage us, ask the LAT for a response to a query which will require their whole team's presence to answer - at about 4pm on Christmas Eve.
    Practices are always responsive to the needs of their patients. After about 3pm on Christmas Eve it is rare to get any contact at all apart from the occasional request for a repeat prescription.
    However, our audit of our online booking in the practice shows that quite a lot of people are at their computers at 2pm on Christmas Day booking a routine appointment. Should we not be open then?
    I am glad GPC is taking this up. Whatever happened to the "High Trust Low Bureaucracy" contract we were sold in 2004?
    In my practice, I will be sitting in the building with a mobile phone switched through from the practice phoneline until 6.30. But my staff will have left at 3 and experience shows I am unlikely to be called.

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  • Fits in nicely with 7 days a week. Why not really go for it 24/7?

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  • I work in an APMS practice so we'll be open until 8pm on Christmas Eve. I'm sure I will have plenty of time to wrap my children's Christmas presents after about 3 o'clock........

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  • I have worked numerous Christmas Eves and from 3 pm onwards, when everyone was in the pub or at an office party, it was always dead as a dodo, and we usually ended up closing earlier than had been planned, leaving a doctor on the end of a mobile phone. Catering for a demand which is not there is extremely wasteful and very bad business practice.
    This has been well thought out by those of low intelligence.

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  • Yes, but,
    This is being set up so that if anything goes wrong at all the NHS management can blame GPs for leaving early and this will fit in to the long game.
    And by "anything" I mean anything and this includes hospital based problems.
    You will be blamed.

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  • I was accused od being in breach when we closed early in 2010 because sheet ice and snow made it dangerous for patients to attend and impossible for us to visit. The duty doctor remained within phone contact.
    As it turned out, even though it was December, the April 2010 PMS contract had not been ratified by the PCT!
    Thge contract appeared rapidly once I pointed this out to the PCT. Happy Days!

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