Hunt tells GPs to 'be brave' and take back out-of-hours care
The health secretary has given his backing for GPs in Hackney to regain responsibility for out-of-hours care following a controversial decision by the previous PCT to prevent them from doing so.
At the NHS Clinical Commissioners conference today, Jeremy Hunt told the chair of Hackney CCG, Dr Clare Highton, that the group should ‘be brave’ and call on NHS England to overturn the PCT’s decision in January and do what they believe is best for patient care.
However, Dr Highton told Pulse that despite the apparent backing of Mr Hunt, the CCG was still concerned that its preferred option of GPs taking back out-of-hours provision could be blocked under competition rules.
Dr Highton said that the CCG was concerned about local out-of-hours provision and supported action by local GPs to take back responsibility.
She told Mr Hunt: ‘We would really like your help and advice on whether we should be brave and ask NHS England again if our GPs can opt back in because as a CCG, that would be absolutely crucial to help us contain demand.’
The health secretary replied: ‘Be brave. That is a perfect example of local clinical leadership, of people locally understanding what it takes to provide an out-of-hours service.
‘It is a major area for concern throughout the country, the provision of out-of-hours care and we have to address that.
‘Sometimes our hands are tied with the processes you have to go through. But you know that if what you are doing is in the interests of patients, you will get there and I would encourage you to do those things to make those important changes.’
Speaking to Pulse afterwards, Dr Highton said it would be ‘hard to say’ how valuable Mr Hunt’s backing would be because of the section 75 regulations, which state that services must be put out to tender unless it can be proved that only one provider can deliver them.
She said: ‘A lot of CCGs are interested in the idea of GPs opting back in to out-of-hours,’ Dr Highton told Pulse. ‘It is a different level of taking responsibility than everyone competing for an OOH contract.
‘His answers on Section 75 suggest we do have the freedom but most CCGs are very anxious about ending up in court, as were PCTs. It is still a very live issue. As CCGs, we can say we would back our practices if they requested it but it is NHS England and/or the secretary of state’s decision as to whether to let GPs opt back in.’
She added that she was worried that there would be problems in court if they took the decision to put out-of-hours care back in the hands of local GPs.
‘We’ve had detailed legal opinions and they said it is anyone’s guess how it would go in a court of law.’
Dr Deborah Colvin, a GP in Hackney who has led the campaign to take back responsibility for out of hours care, said: ‘I find it quite interesting given that I wrote to Jeremy Hunt asking for his help after the PCT made its decision and he wasn’t interested.
‘It blows my mind really…. I think it is just him soundbiting. I have seen no evidence that anyone in the Department of Health gives a damn about local people getting what they need.’
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Readers' comments (13)
Jobbing Doctor23 Apr 2013 6:20pm
It's not brave, it's bonkers!
They thought their beloved private sector could do it better and cheaper and they were so utterly wrong.
However, unless it is financed and organised properly, no sensible `GP will touch it with a bargepole.
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Cobblers23 Apr 2013 11:33pm
Go forth and multiply says the bible. Good advice for Hunt. No way in hell will I take back OOH.
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Bob Hodges24 Apr 2013 10:49am
What an idiot.
He own rules force these services to be tendered out to the lowest common denominator low-ball private sector bid.
Local commissioners don't have the power to apply discretion over this......
...unless Hunt wants GPs to take it back AND undercut Harmoni. Another politician wanting to have YOUR cake AND eat it.
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Jonathan Harte24 Apr 2013 11:01am
OF course Mr Hunt would like GP's to take back OOH's - yet another area to pass the responsibility and therefore blame back to Primary care., if and when it fails again.
He'd be smiling all the way to the office.
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Andrew Mimnagh24 Apr 2013 11:17am
"They Paved Paradise and put up a parking lot" is required listening.
Yes HMG is happy for GP's to volunteer to take back OOH, it overlooks the derisory value they placed on the commitment at the new contract negotiaions and yes , unless we want to be bashed in the " Red Tops" we have to do it for less than the private sector currently do.
The plus point is that is more than was on offer at new contract, the minus point is it is still substantially less than the continuity of care is worth and the ultimate "deal breaker", a volume of expectation that will have you dead if you try to do the old GP 1:1 or bankrupt if you try to resurect a cooperative.
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Vinci Ho24 Apr 2013 2:09pm
Clever , so cunningly clever
(1) The debate at the level of principle of whether it is the 'right' thing for GPs to be responsible for 24 hours care can go on forever . If you simply ask a patient whether he or she likes her GP to be 'available' 24/7 . Of course , yes. This is the loop hole Agent Hunt will try to squeeze in .
(2) What he will never mention to people is the rule of the game is completely changed now . The benevolence of those GPs who wanted to opt back is betrayed by the new Health Bill section 75.
(3) Of course , it is 'be brave' because he is bidding you farewell to walk into a mine field where sooner or later you would lose an arm and a leg.
Well done , Agent Hunt, this message will self destroy in 5 seconds .......
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Anonymous24 Apr 2013 3:09pm
Hunt's proposal has the tacit approval of the RCGP.At a recent talk by Clare Gerada she mentioned that OOH responsibility should be borne by GPs
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Anonymous24 Apr 2013 5:50pm
'Be brave' and then they impose what they chose to do. We GPs are chumps - utter dopes. The DOH will start well, pay reasonably and then cut the tripe out of us.When will we ever learn. How, for example, can there ever be an imposed contract any where in the world. It is a logical impossibility.
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silver surfer24 Apr 2013 5:52pm
In Northern Ireland it looks like we will be taking back our OOH care also.Best described by our GPCNI Chairman as "better to get Humpty Dumpty now rather than when he falls off the wall and is beyond repair"
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Anonymous25 Apr 2013 0:39am
Lets see.
(13.5hrs x 5days + 48hrs)x52weeks + 24hrs x 8 bank holidays = 6200hrs/year to be covered.
Assuming you'll need one GP per 8000 patients, you'll need 2 GPs at anyone time to cover my practice. Even if I can secure someone who's willing to work at normal hour's rate, that'll be 80 pounds/hr x 2GPs x 6200 hours = 996k/year. And that's even before indemnity cover, admin staff, operational costs, unsociable hours pay, superann etc etc.
So unless the government is willing to provide an uplift of 1.5million for my practice, no way I would touch OOH. They'll have to remember the culture is different now from 10 years ago - patients now expects to be seen for any problem at anytime of the day.
And if they impose a new contract to enforce GPs to take OOH, I can guarantee there won't be any sane GPs who will work in this country.
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