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Seven-day GP recruitment incentives 'unsustainable in the long term'

Seven-day access pilots had to pay extra to GPs to fill shifts during extended hours, a situation which is unlikely to be sustainable in the longer term, the official evaluation has concluded. 

The report into the first wave of the Prime Minister’s Challenge Fund (PMCF) pilot - which also suggested Sunday appointments should be scrapped due to low demand - said that the pilots faced problems with recruiting GPs, often finding themselves ‘competing’ with out-of-hours providers.

As a result, many resorted to offering financial incentives, which ‘may not be sustainable in the long term’.

Pilots also struggled to recruit advanced nurse practitioners (ANPs), the evaluation found.

The researchers added that they expect that all local health economies moving towards extended access were likely to face these same issues.

The report said: ’Wave one pilots did experience some capacity issues, which manifested themselves often as difficulties in recruiting or competing with out-of-hours providers for GP time.

’The short-term nature of the contracts of the pilot schemes also contributed to this.There remains some concern around the availability of ANPs in particular, which are likely to be exacerbated as more local health economies press ahead with seven day services and introducing skills mix.

’Similarly, to date some pilots have relied on incentivising GPs to resource PMCF initiatives and this may not be sustainable in the long term.’

It comes as Pulse reported that one of the Manchester Demonstrator seven-day access schemes, hailed by the Prime Minister as a blueprint for the Challenge Fund, is having to pay GPs £90 per hour to fill shifts, almost two years after beginning to offer extended hours.

Readers' comments (11)

  • £90 per hour is cheap!!!

    Most locums in our area are charging £100 per hour in weekdays!!

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  • £90/hour is not going to get a GP who is already doing 50+ hours a week to do more. The only way 7-day access will work is enforcing it into GMS contract with or without money.
    It still would not be sustainable anyway as anyone who could afford to would jump ship.

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  • Step 1 - incentivise a voluntary 7 day contract .......
    Step 2 - ......with money stolen from a shrinking GMS contract
    Step 3 - GMS withers away
    Step 4 - impose 7 day contract on all, with GPs contractually obliged to cover weekends for no extra pay.

    Brilliant. Just a shame there won't be any GPs left by then.

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  • Don't worry about there being no GPs in the future. According to the story, there aren't any GPs left now!

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  • Locally hourly rates are almost double for PMCF routine extended hours compared with OOH - a no brainier for a locum
    Results in understaffing of OOH - 'OOH is not working' they say

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  • Vinci Ho

    From day 1, this is a heavily politicised subject no matter which side you are on and that is a fact.
    The theory and principle behind running 7 days GP opening(arguably together with 7 days NHS) are ideological. Without sufficient 'tools' , an ideology remains as an ideology.
    If this government persistently insists 'living within our means' is the way forward with the economy(which is in itself another ideology), the ambition of having the first 7 days health service in the world is totally against this ethos. The simple truth is 7 days GP is not affordable as far as this government is concerned .
    But like any other political agenda to be pushed off, some kind of sugar coating is provided first (as in the pilot schemes) to sustain the feasibility argument of this luxurious ,first in the world 7DGP(and NHS). I see some similarities of using minimum living wage to support the argument of cutting the tax credits substantially .
    But life and fate is not quite like that , Mr Cameron, Mr Osbourne and Mr Hunt , there is a god somewhere for those who believe . On the night when our famous British spy was welcomed in the Spectre Primer in Royal Albert Hall , not too far away in House of Lords, the House of Common's legislation of tax credit cut was significantly defeated twice (although it is not legally bound). This is only the fifth time in history since 1945 when the Commons were negated by the Lords considering the members of the former are all elected while those of the latter are NOT. This , in effect, represents a parody ( in fact , more humiliation)to our democracy. The Lords( traditional icon of the previledged ones in contrast to the common people represented by the Commons) were standing more by people in this instance. Ironic?
    The biggest question is how much you can trust this government with public services . It is fine to say Cameron and Osbourne is the best combination for running the economy but it also begs the question how much are they willing to ruthlessly sacrifice to deliver the rise in GDP and acquire surplus in 2020.(not to mention the recent grovelling to our 'great' Chinese President).
    For those who want to remain as protagonists of this 7D NHS and GP opening , think again whether your ideology has really been used and exploited by these despicable politicians for their agenda OR are you actually part of their gang(which I suggest you look at your mirror to find your reflection again)?
    Accuse me of playing with sensationalism , by all means!

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  • Vinci Ho

    Chelsea 1 Liverpool 3
    You see
    There is a god. The way the 'special one' treated our medical colleague , he was well punished by our 'normal one' today.
    (Sorry , ignore this comment if you are not a football fan)
    Agent Hunt , watch your a**e

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  • 30 Oct 2015 10:03pm

    got it in one.

    btw £100 per hour just about covers defense union costs - i'm leaving ooh work as I will end up paying the defense union more than what I earn - so there is no point in occasional OOH shifts for me. I can do without the 'danger money' as I don't want to breach 56 hours per week !

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  • Vinci Ho | GP Partner31 Oct 2015 3:07pm

    Chelsea blame their woes on .. wait for it a doctor !

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  • Sustainability of the rates is not related to the free market rate for these sessions(or even locum free market rates)it is related to supply and demand.With regrets the supply of GP prepared to do these sessions and pay rip off indemnity in and pay 40-50%+ tax rates is dwindling therefore they will cost a lot more.Once commissioners and government understand this they will understand the conundrum.They either have to pay a lot more,increase supply of GPs or do both neither of these will be quick or cheap.The other alternative of supplying Noctors that are prepared to take the risk GP/medics take will in the end will not be cheap either.In the end the "seven day"political idea the Tories have is UNSUSTAINABLE.They need to work with what they have or ultimately destroy the golden goose.?Have they played their hand to soon without having an alternative in place,or have they played a blinder,only time will tell.It is all so sad.

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