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‘Successful’ seven-day scheme could close due to lack of funds

A ‘successful’ PM’s Challenge Fund pilot may have to close because its cash-strapped CCG is unable to guarantee continued funding for extended access beyond April.  

Dr Richard Dales, who is the director of Taurus Healthcare Limited, which runs the pilot scheme in Herefordshire, said that he would like commissioners to consider reducing Sunday hours to secure enough funding for extended hours at other times.

He added that the scheme had filled just over half of appointments on Sundays. 

The comments come on the same day that Pulse reported that eight of the 18 ’Challenge Fund’ pilots - including Herefordshire - have reduced weekend services or cut the service altogether.

Dr Dales, who is also chair of Herefordshire LMC, told delegates at a Pulse Live event in Liverpool today that the scheme - which is part of the first wave of seven-day working pilots - was successful, and had reasonable uptake from patients, particularly in evenings.

He added that it had already seen its funding reduced in its second year, despite area team support.

Its future now hinges on a CCG which, like others nationally, is struggling to balance budgets and manage secondary care activity to fill the £22bn funding black hole facing the health service.

The Prime Minister’s Challenge Fund provides funding to seven-day access pilots for 12 months, after which CCGs are supposed to fund them through savings made from reduced A&E and secondary care demand. 

However, CCGs have been unwilling to make public their plans for the schemes beyond this month, stating that they are waiting on an NHS England evaluation of the pilots, which is due soon. 

But Dr Dales told delegates that future funding was uncertain.

He said: ’NHS England continue to fund it in the second year the CCG is short of cash like most of the others. They’ve got a trust in severe financial difficulties.

’The area team were very keen to support us going forward. So we’re continuing seven-day services, but it’s been adjusted so we’re doing a few less on the weekends and we’re using our Hereford hub more often.’

He added:’There is political will [but] we need to persuade our CCG colleagues who are under a lot of financial pressure to continue the service and continue funding going forward.’

‘If after April the funding goes, the service will go. We can adapt the service, but we can’t do it without the funding.’

The scheme operates from three hub practices in Hereford, Leominster and Ross-on-Wye, offering urgent and routine appointments - typically 12 minutes with the scope to increase them - and telephone triage. But it doesn’t offer home visits.

It initially ran additional hours from 6pm to 8pm on weekday evenings, and 8am to 8pm on Saturdays and Sundays, and now fills 97% of its evening and Saturday slots, and 53% of those on Sundays. 

Dr Dales added: ‘If they want to provide less money we have to reduce the services we provide. I’d like to see a bit less on the Sunday and more in the evenings, demand in the evenings is pretty high.

’Sundays we see a lot of urgent stuff. If Saturday fills up, we let it trickle over to Sunday.’

Readers' comments (11)

  • The Challenge fund is just another way of increasing healthcare inequality and adding to the inherent unfairness in financial allocations to different areas.

    Why do patients in neighbouring areas get so much difference in pounds per patient?

    Why are not all areas given extra funding to try innovative working?

    Why is the historical funding inequality now locked in due to all budgets based on the old unfair allocations?

    Sort out the day to day funding so practices are on a level playing field to the huge APMS contracts that are still being handed out in places.

    Recruitment gaps of 50% in new GP scheme placements will not replace retiring/escaping and part time GPs, let alone allow for political suicide 7 day opening.

    Please start to see past the political agenda and realise a shrinking NHS budget is not going to stretch much further.

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  • Trusts in deficit, next yrs funding unclear due to PbR tariff changes, and the only flexibility in funding is from diminishimg non recurrent reserves as the belt tightens on CCGs financially - little hope remains for any significant investment in primary care. Government barking up wrong tree with 7 day access - what is needed if system is to change is to fund development of GP provider networks so they can achieve meaningful transformation of primary care, control of spiralling referral demand, and decommissioning of excessive Trust activity. This should transfer funding more proportionately to primary care and result in a more efficient spend of dwindling NHS resources. I know the answer for some is just to pour money into primary care - which it does need - but without more fundamental change to out of hospital care we will still be faced with a non viable NHS within a decade. Of course the other option is to stand watching while everything crumbles and then pick up the pieces as private providers. Maybe this is what the Tories want, to dismantle the expensive state run health service similar to the destruction of the minimg industry and consequently the trade union movement under Thatchers watch.

    So do we take up the mantle, diversify our businesses, work at larger scale, or do we take a fatalistic approach and deal with whatever is left after everything collapses?

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  • Time to put the waste of this 7 day rubbish to bed
    This nonsense cannot be afforded
    Yet another lunatic scheme starving money from evidence based care such as continuity of care
    It is vital to end all cooperation with this perverted governments mad delusions and criminal waste of public money
    There is precious little evidence this lunatic scheme reduces a and e pressure ..even if that was the goal(it is not it is a demagogic sop to highly paid London workers who are not prepared to sacrifice some of their income to see a GP during normal hours )what is needed is obviously to strengthen ooh services and end 111.
    To be fawning to this ...of all governments bribes .. For this idiocy is unconsciable
    CCGs ..please liquidate funding for 7 day minor convenience care and spend public money ethically instead.

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  • Time to liquidate this wasteful scheme nationally
    Poor evidence
    Damages appropriate use of GP
    Acts contrary to decades of patient education
    Damages continuity of care
    Is a pet project of an ignorant disgraceful pm who is causing catastrophic damage to patient care
    A plague on him and his arrogant stupidity and his tiny minority
    Mr Cameron 75 percent of the people do not support you
    Neither imho should one single GP in this country
    Any pm who has presided over the evil brutal mistreatment of the disabled as he has deserves eternal contempt
    I like most gps have seen this personally and revolts me

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  • Vinci Ho

    The lack of honesty , honour and transparency of this government is phenomenal . Those who still 'support' the Tories obviously disagree to that. But the clandestine agendas behind what they are doing to the health service is more than apparent . William Beveridge would be so hurt to see this if he was still alive.
    The typical SciFi story to destroy the world(NHS in this case) bringing along apocalypse before restoring 'new order' , is the 'ethos' of this efficiency saving and of course , Health and Social Care Bill . 7Ds opening is just another catalyst in this chemical chain reaction......

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  • Drachula

    Stop wasteful 7 day opening and send the spare doctors to Prestatyn

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  • Yes Vinci, Fish rots from the Head - transparency is not something we can expect at any organisational level in the NHS or at the government level.Not till the old order has been replaced by a new yankee order. For our politicians even yankee poops are more holy than our NHS.

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  • Maybe it's just me, but isn't 97% of appointments being filled on evenings and Saturdays showing that actually people do want these evening and weekend services? I agree with so much of the anti-seven-day debate, but perhaps we need to be a bit more balanced?

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  • There are two types of people who want evenings and weekend appointments, those that wnat convinience as they work, child care etc... and those that cannot get weeekday appointments because there aren't enough GPs.
    Pandering to the first group makes the 2nd group larger as I'm not working 7 days a week.
    Fund in hours properly and and 7/7 drive will shrink away as we can offer more pre-booked appointment. This ain't rocket science is supply/demand! If Aston MArtn sold DB9s for a fiver they wouldn't keep up with the demand, they don't because they have a value. Can't afford an Aston- drive a Polo. NHS same it ain't gold plated but it'll get you from A-B when needed, but must be maintained.

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  • A success?
    Starve primary care funding by 25% in relative terms over 10 years, pump up demand with political rhetoric, publicise ridiculous "rights", dump more and more 2ry care work into primary care, stop admitting patients who need to be admitted, clamp down on referrals, add in layers of regulation and bureacracy and then mix in many more treatments for many more conditions all of which need more monitoring AND THEN under all that pressure toss a quick £250M into the system and see the sudden offer of appointments at 8pm are taken up. You call that a success?
    I'm astonished the extent to which peoples eyes have been so easily taken of the target.
    Regards
    Paul C

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