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Practices will not have guaranteed funding for extended hours access

There is no guarantee GP practices will continue to receive funding for the provision of the extended hours access DES, under the new GP contract.

From July, the extended hours access DES will be transferred from practices to the new primary care networks.

The change, which forms part of a the five-year GP contract, means NHS England will no longer directly pay practices to deliver the service, although the BMA said the money should flow from the networks into the practices.

Under existing extended hours DES, practices are paid to ‘offer patient consultations face to face, by telephone or by other means at times other than during the core hours’ as stated in the contract.

But NHS England said it intends to move the service’s requirements and funding to networks in a bid to better join up the urgent care system.

BMA GP Committee chair Dr Richard Vautrey told Pulse practices 'will not get the money directly', and explained it will be allocated to the networks, which will then decide how to disperse the money between the practices.

Although Dr Vautrey could not confirm whether practices will be guaranteed to receive the funding, he said it ’should flow back to practices through the networks’.

NHS England said rather than ‘removing’ the current pot of funding for the extended hours access service, which totals £87m, it will 'transfer' the money to networks from July 2019.

This will come on top of a recurrent £30m, which will be added to the global sum in 2019/20 to 'reflect the increased population coverage of the extended hours access requirements' and fund the new 111 direct booking service.

The contract said: 'Transition will begin on 1 July 2019.

'Instead of allowing the extended hours access DES to draw to a close, removing £87m a year from general practice contract funding, we have agreed to transfer the extended hours access DES requirements and existing funding to the network contract DES from July 2019 until it becomes part of the funding for the combined access offer in April 2021.'

The primary care networks – which will cover 30,000 to 50,000 patients and be led by a local GP in a clinical director role – were announced earlier this month, with practices being mandated to join them in return for a £4.5bn funding boost.

According to NHS England, an average network with a population of 50,000 will be required to provide 25 hours extended access per week, which will be shared between morning, evening and weekends.

’All extended hours slots would, as now, need to be delivered by the constituent practices of the network’, it added.

Dr Vautrey said further documents detailing the structure of primary care networks and how they will work will be released in the next couple of weeks.

NHS England previously told CCGs to ensure the new primary care networks are in place by 30 June at the latest.

Find all the headlines from the 2019/20 GP contract here…

Readers' comments (9)

  • i have just read this 100 page document. be afraid very afraid......

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  • Agree- most funding going to CCGs not direct to practices and to “alternative ( cheaper imitation GPs ) staff” army and CCGs for “creating” networks....??
    No longer able to see private patients as NHS GPs( hospital consultants can????)- some may be against the idea but a small flow of private patients was the only thing that kept our NHS practice viable- it’s not worth my whole working 15 hour solid days for the nhs money alone.....
    Looks like the end for us

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  • For anyone worried about losing extended hours, just take part in your network. It is fairly easy to just devolve the funding and work downstream, to the practices - then staff it in just the same way.


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  • Will the funding to networks mean that folks will be valued for working extended hours, no mention of out of hour but bet that will be devolved to networks.

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  • Have we had notification that the current extended hours contract has been extended past its 31 March contract end date ?

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  • I think this contract implies it runs until the summer -then changes to networks.

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  • Historically anything delivered in primary care by our local ccg has been sliced.

    Our approach is that we will evaluate any offering from the ccg and if not viable then we will simply stop doing the work.

    General practice needs to develop alternative income. I highly suggest that you start to make contact with your local CRN. Research has replaced some other incomes. Great for the patients and more than enough work is available. Private patients by other providers such as spire hospital group is another good one.

    What we have found is that it means that we don't need to stop doing core bread and butter general practice. We just don't need to do the other stuff!

    - anonymous salaried!

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  • The principle of the NHS giving with the right hand and taking with the left stays. Privatisation is the way to go to stop these yearly contract reviews that we are all fed up of. Part of the money will let CCGs expand their empire and transfer what is left to get you to do more risky work.

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  • Does this mean we have lost the ability to decline extended hours?

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