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Independents' Day

'Punch drunk' GPs unable to staff out-of-hours services

NHS managers must urgently develop a model to predict how many GPs are needed in the future, otherwise out-of-hours services are likely to suffer warns an influential committee of MPs.

In a report published today, the Public Accounts Committee said the lack of basic GP workforce information at the ‘most basic level’ was a key problem in guaranteeing the future quality of out-of-hours provision.

And GP leaders said that it was important NHS England ‘got a grip’ on an ‘increasingly chaotic and underfunded system’ in out-of-hours.

The report comes after the National Audit Office in July showed that 60% of out-of-hours providers had struggled to fill their rotas, which the GPC attributed to GPs being ‘punch drunk’ from overwork.

It criticises the NHS England and the Department of Health heavily for a lack of oversight on out-of-hours services, and recommends developing methodology for ‘understanding the significant variations’ in costs and patient satisfaction with services in different areas.

The report states: ‘NHS England does not currently have a model to predict how many GPs will be needed in 2020 and does not intend to develop one until it has more certainty about the NHS budget to the end of the decade.

‘In our view, NHS England cannot afford to wait for budgets to be set given the time it takes to train new GPs.’

And the report also calls for an overhaul of the ‘perverse financial incentives’ which undermine attempts at providers working together, such as the payment by activity system in A&E departments. It says: ‘Given the pressures on the NHS budget it is important that NHS England should expedite the redesign of urgent and emergency care services.’

NHS England chief executive Simon Stevens told the PAC earlier this year that the GP recruitment strategy in the past decade had been ‘crazy’.

GPC chair Dr Chaand Nagpaul supported the analysis, saying: ‘Many GPs are working hard to deliver out-of-hours to patients, but they are being undermined by an increasingly chaotic and underfunded system.’

Dr Maureen Baker, chair of the RCGP, said: ‘We desperately need at least 8,000 more GPs in England alone, so we welcome the call by the Public Accounts Committee for NHS England to urgently address this need.’

A spoksesperson for NHS England said: ‘GPs are working incredibly hard, and for less than the cost of a cinema ticket they provide everyone in this country with year-round access to out of hours GP and 111 services.’

‘What’s more the real terms cost of doing so has been coming down year by year. This report, which looks at the position a year ago, is however right to underline the benefits of much greater integration of GP, ambulance, and hospital emergency and urgent care services as proposed in the NHS Five year forward View.’

Readers' comments (12)

  • Vinci Ho

    You see, this political drama is heating up and more , more entertaining:
    Simon said , the GP recruitment strategy has been chaotic and underfunded. This perhaps had infuriated the central nervous system of the government . Last few days , the PAC( still a bunch of politicians) dug out the NAO report (which I think is still relatively objective) and blamed the roll out of Better Care Fund as shambles. The finger is clearly redirected to NHSE. Hence NHSE has to get a 'grip' on this . I am afraid CCGs will be dragged into this (so called devolution ?).

    Still remember the internal duel between Michael Gove and Theresa May, ladies and gentlemen ?
    The leading up to this general election can be potentially the dirtiest campaign of modern times.........Love it , absolutely love it.....

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  • Vinci Ho

    Simon ,ten thousand arrows pierced through your heart, not pleasing your bosses, not pleasing these 'lazy , fat bottom(try to be polite)' GPs........

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  • Vinci Ho

    Somehow , the image of one of my nemesis , Harvey Dent , is rising in my mind........

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  • Harry Longman

    So easy to wave shrouds. So hard to think differently - but that is what is required.

    All the players in this debate are arguing over the size of the pit and where the bottom is. No one is thinking how to walk round it.

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  • They don't need to walk round it when they can shove enough GP's into it to form a bridge that would than allow Private enterprise to cross with ease!!

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  • Harry Longman - "Think differently", that's what all NHS managers say when they have no idea what to do. More money and sensible long-term planning is required. Not silly gimmicks like Skype consultations!

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  • Bob Hodges

    Please show me how to be 'fresh enough' after my shortened my 10 hour day to turn iot into a 15 hour one with an OOH shift at the endo of it Harry!

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  • ..GPs drunk on punch?...outrageous couldn't make this stuff up

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  • Yes Harry is here again.Aren't trolls said to be slow, dim-witted and live in holes in graves which no-one would go near let alone"walk around"?

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  • The steep increase in indemnity costs, which has not been covered by increases in remuneration reduces the incentive to take up this work, and limits the amount that can be taken on.

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