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Gold, incentives and meh

GP opening hours to be included in NHS review of urgent and emergency care

GP practice opening hours are to come under scrutiny as part of a national review of urgent and emergency care being launched by the NHS Commissioning Board.

The review - which forms part of plans to introduce more seven-day working across the NHS in England - will be led by the Board’s medical director Sir Bruce Keogh.

Sir Bruce recently told the Sunday Times that GPs should be prepared to work at weekends for the benefit of patients in an effort to emulate the customer service offered by Tesco.

He said that primary and secondary care clinicians should move towards seven-day working as the current system is designed for health workers and not patients.

In a statement the NHS Commissioning Board said the urgent and emergency services review team will work with CCGs to develop a national framework offer to help them ensure high-quality, consistent standards of care across the country.

It said the review will take account of the way that emergency care in England works with other areas of the NHS, such as GP surgeries, community care and the 24-hour NHS 111 advice line.

A Board spokesman confirmed to Pulse that the review team would examine the whole NHS - including GP surgeries and out-of-hours care.

The review team will publish emerging principles for consultation in the Spring.

In its planning guidance, published late last year, the NHSCB said it would order the review as part of plans for more seven-day services.

As well as seven-day working, the review aims to help CCGs find “the right balance between providing excellent clinical care in serious complex emergencies and maintaining or improving local access to services for less serious problems”.

It will set out the different levels and definitions of emergency care ranging from top-level trauma centres at major hospitals to local accident and emergency departments and facilities providing access to expert nurses and GPs for the treatment of more routine but urgent health problems.

As well as looking at how emergency care is provided, the review will also assess transfer processes between these levels of emergency care.

Launching the review Sir Bruce said: ‘The NHS is there for all of us and should offer appropriate, effective and rapid care whenever and wherever it is needed.

‘Treatments for many common conditions such as heart attacks and strokes have evolved considerably over the last decade and are now best treated in specialist centres. Yet we know people want their A&E nearby.

‘This makes me think we need to review the increasingly complex and fragmented system of urgent and emergency care, so that sick, anxious and often frightened people can get what they need when they need it.’

Readers' comments (19)

  • Spencer Nicholson

    OMG Sir Bruce what are you saying. Let's think about it work 40 hrs a week but need to cover 56 hours for 7days at 8 hours or if he is suggesting 12 hours a day 7 days a week 84 hrs mmmm sounds good. Just the demographic time bomb of approaching retirements and not training enough gp's in the first place seems to leave a great big gap in the workforce to achieve Brucie's aspirations.
    Inflating patients expectations and then saying get the lazy bastards to work harder for less money
    Some recruiting poster!
    Again so bloody glad I am now in Australia!

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  • This is what will happen. A review, shortly followed by an imposition from the governement to extend GP core hours. How will this be financed? Nothing extra, you can be sure of that. Pay from one GP revenue stream will be diverted to fund this. If GPs dont reorganise to provide 7day a week care 8am to 8pm, they will therefore receive a pay cut. However it will cost more for staffing, building costs, cleaning etc. Who will finance that? GPs of course. One doesnt have to be a sage to see this coming, just to have worked in the NHS for a few years

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  • one point that seems to have been completely missed in all this obsession with TESCO as a great example for the nation is that said Tesco has not done very well in recent years. ? loss of quality? i think so. and the same would beset NHS General Practice as, unless it really was very well rewarded, it will lead to a further erosion of motivation amongst doctors and usage of cheaper staffing solutions.
    it may cover the hours, but you are not going to get the experienced doctors doing them who could really make a difference in terms of patient's use of secondary care resource.
    and to the chap who criticised Terry Jones, very happy to be more equal but it would have to include our friends in management, lawyers and many more...
    all you will achieve is people thinking twice before making GP a career choice and those in it already will look elsewhere

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  • It's true that you can shop at Tesco whenever you feel like it, be it 3pm or 3am or whatever.
    However you won't see the same cashier every time you turn up - the one who knows you, and can carry on the conversation you had last time you saw them. Because of course, it wouldn't matter.
    This is not the case with primary care!

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  • This doesn't only affect GPs, we'd have to have a nurse and admin staff in too. I can see a mass exodus.

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  • I doubt that Sir Bruce Shops at Tesco!

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  • 7 day opening is already here - walk in centres that operate in various guises from 8-8 or 10pm and run as GP surgery are already in existence. I know its not for everyone, but i opted for the benefits of some flexible days off during the week vs working a weekend a month, i suspect this is partially the governments idea of what they would like in Gp surgeries. What they probably haven't factored in is the cost of operating 7/7. I see a large number of people through the service who cannot get into to see their regular GP due to no appointments or the hours are not conducive. Gone are the days when people would take time off. From my experience, the only ones in the surgery during current opening hours are the elderly, yound parents and small children and those who don't work too much. Effectively current GP opening hours are missing half the population out.

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  • I spoke to somebody in out local Tesco store today they employ 350 staff.

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  • I think the Govt. want to spread the work load over seven days to suit the tax payers. Speading the workload loike this will cost extra labour, heating and other semi variable costs.
    Do not be feart girls! The country cannot afford this type of service. The review of urgent care will figure this one out - I assume there are no bright ideas which will prove me wrong!

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