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Budget for seven-day GP access doubled to £750m, announces Treasury

The budget for seven-day routine GP access has almost doubled in a year, with the Treasury to announce tomorrow that it has allocated £750m to rollout the ambitious election pledge.

The cost of the scheme will be up 90% on the £400m originally announced in 2014, but Pulse has learnt that this funding is likely to be recycled from other funding promised for general practice in order to prop up the scheme.

The Treasury was unable to clarify to Pulse whether this £750m includes new funding, but the GPC has said that it ‘suspects’ this is a rebadging of old money, potentially the £1bn ’infrastructure fund’ announced earlier this year to improve GP premises.

The announcement of the increase in funding for seven-day access comes as a Pulse investigation reveals that only two of the 19 CCGs in the first wave of the seven-day ‘Challenge Fund’ pilots have committed to continue fully funding the schemes long-term.

Two of the wave one areas have completely scrapped seven-day working, and 13 CCGs are still reviewing their options, the Pulse investigation has found.

An evaluation of the wave one Challenge Fund schemes in October found they were associated with a £3.2m estimated saving - due to a reduction in minor self-presenting A&E attendances - but this was dwarfed by the schemes £50m initial funding.

It also suggested that Sunday GP appointments should be reconsidered due to ‘low utilisation’.

Ahead of chancellor George Osborne’s Spending Review announcement tomorrow, the Treasury has announced that £3.8bn funding would be pumped into the NHS next year, as part of plans to increase the annual budget of the NHS by £10bn by 2020.

It also released a statement saying: ’By 2020, everyone will be able to access GP services in the evenings and at weekends. This will mean 5,000 extra doctors working in general practice, with £750 million of investment, the Chancellor will announce.’

However, this stands in marked contract to the £400m ‘set up costs’ spread over the five years from 2015-2020 originally quoted by Prime Minister David Cameron and is less than the £1bn a year that the RCGP has said seven-day GP routine access could cost.

Deputy GPC chair Dr Richard Vautrey said: ’There is no point funding something that patients don’t want and it having an impact on other services. What you need to do is fund core services and urgent care services.

’Unless you’ve got recurrent funding to sustain these developments then it is difficult to see how it doesn’t impact on the current service. But I suspect that £750m is already announced and rebadged money. It has been announced in various ways - as the access money and the premises money before that.’

The original primary care ’Infrastructure Fund’ was announced earlier this year, but was recently rebranded as the GP Transformation Fund and has already been used to prop up seven-day access. Pulse learned in July that £25m of the £100m funding for the second wave of the Prime Minister’s Challenge Fund pilot rolled out this year stemmed from the fund.

In addition, £10m has been siphoned off to support struggling GP practices to stay open, and the GPC has warned of a significant underspend on the money that NHS England already claimed was handed to GP practices. 

Meanwhile, although NHS England had claimed that ‘over 1,000 practices’ had been awarded a share of a first £190m tranche, Pulse revealed that practices have actually had millions of funding revoked. 

 

Readers' comments (29)

  • This is a farce and an insult to primary care.

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  • Took Early Retirement

    By 2020, everyone will be able to access GP services in the evenings and at weekends. This will mean 5,000 extra doctors working in general practice.

    This just isn't going to happen without hospital doctors being kidnapped and dumped wholesale in GP practices. As the Romans would have said, "Fieri non potest".

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  • 7 days service but no doctors to see them

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  • When will we have evening and weekend access to our MPs? Actually, in hours access would be nice, a reply by email within 28 days would be nice.

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  • ... and the (increase in) funding for 7-day access to pharmacy is still bugger all!

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  • £11.50 per person per year.

    What will that buy exactly?

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  • yet another stupid plan from a dept of health that doesnt have a clue - as my colleagues have already said where are the gp's to do it - with what we are expected to do already and an ageing population and more hours to be worked I suspect it will be nearer 10,000 more gp's required

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  • Not enough to even pay for the rise in indemnity it will cause,think again posh boys!

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  • The UK is a festering pile of dung

    everything is decided from top down and the serfs at the bottom that actually do the work, have to put up with the never ending faeces thats keeps flowing

    professionalism is dead

    respect is dead

    autonomy is dead

    will the glory days ever return????

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  • Makes total sense to me. After all, we’re awash with funding, we’ve got a surplus of medics and it’s a basic human right to be advised by a proper doctor, to put a plaster on a cut finger at any time of the week, day or night.

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  • Ivan Benett

    This is, of course, excellent news for people who can't access their GP during normal working hours. Those who work, for a start, but also those with carers who work, child care duties and other duties. Sunday utility is an issue at the moment mainly because people don't know that it's available.
    But this needs to happen with an expanded Primary Care workforce, not just GPs but nurses AHPs and the wider Care system.
    The team will need to be more proactive in managing those people with same day need, including those with long term conditions where an early intervention prevents deterioration. Better end of life and nursing home care too. I think this is very exciting, also what people voted for, and what people consistently say they want.

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  • Apologies for the anonymity Ivan but when you've delivered all of this can you proactively work on family time utility, the Ponzi superannuation scheme and World Peace, all within the constrained funding envelope?

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  • Think you'll find most people did not vote for this rabble Ivan. I assume your oozing enthusiasm is serious sarcasm?! after all if you ask the public if they'd like their GP parked outside their gate day and night (just in case) for no tax demand at all they'd all love it too. the way you're talking is perpetuating further the "it's my right" attitude…. funny that asking Doctors what the want or can provide isn't being considered, and why should it be properly funded?

    We already have WICs, OOH all over the country (can people not take some responsibility for finding the time to see their GPs like we have to to see their hairdresser / white goods deliveries, dentist etc)- we simply need proper funding and indemnity cover for the GPs working already outside 18:30 (or instead simply access the Noctors who NHSE feel are an easy replacement for our clinical skills). Who is going to pay for the HUGE increase in indemnity needed to provide this Tory vanity project? The jump from 7 to 8+ sessions is frightening.
    Absolute joke, at least RCGP also welcome this ongoing fall of excrememt on us from a great height. Recruitment problem - just cannot see why.

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  • Patients should pay for extended hours consultations. This would draw in funds to the health system whilst creating value to patients who would pay for extended hours appointments.

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  • The best thing about this is that it will improve nothing but
    1) kill ooh and urgent care- doctors will chose the better paid one with less risk
    2) increase demand - see noctor on saturday/sunday (no change of seeing a doctor, he is dealing with the "urgent" which should have gone to a+E in the first place)- you need to see your GP on monday for a prescription/referral/proper doctor assessment/I haven't got a clue but see someone who does and cares/at least I got my £75 for seeing despite not having done a thing to help except redirect you back to your GP who gets paid the same amount to provide unlimited service for you all year round
    3)destroy what remains of true on the ground primary care
    4) and finally privatise primary care once and for all. the ultimate aim.

    I can't believe our own colleagues stab us in the back (no names mentioned but you know who you are above) but all I have to say is "et tu brutus". Good luck for providing this service which will not be there in even 10 years time.

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  • absolute insanity and a criminal waste of taxpayers money...there are numerous far higher medical needs..who will suffer for pissing 750 million into wind?on the mad altar of decadent selfish me me me convenience that i for one resent in the extreme my taxes will be wasted on..as i use this service RESPONSIBLY..as it was set up for.
    employees have a right for time off for medical care in any case..that is the elephant in the room..but woe betide tories would ever cut the massive subsidies for corporate welfare...
    those that fail to do so should have legal action taken against them.
    i would agree to the return to sat am surgeries and some late or early surgeries.. but ONLY for full time workers..any more access is not required.

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  • 7 day access will destroy continuity of care, disadvantage those who want regular, geographically convenient access to their own doctor - not A.N. Other at some distant location, diminish respect for GPs when GP appointments are so de-prioritised, increase pressure on workers to use weekend access rather than taking time out to see their own doctor, destabilise OOH services, further damage retention and recruitment of doctors, increase costs for any doctors left, complicate treatment when some random doctor with a different approach and no previous knowledge of the patient becomes involved.....and for what? So that some politician with no understanding of health care can claim "credit" for "improving" the service. Why can certain GPs not see this? We wouldn't be heading for this mess if we had all just refused involvement at the start. Sadly, it only takes a few to play along.

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  • Ivan will only ever focus on his agenda
    Instead of funding regular hours care which is at breaking point lets fund appts at evenings and weekends for the few who find the current set up inconvenient.

    I worked extended hours just over 3 years ago. We worked from 7:30 until 8:30 for an extra hour in the morning as well as other times from 6:30 until 7:30

    We also did Saturday morning clinics. What did we find?? Low uptake and for the most part those that did book were the usual suspects with the same old nonsense.

    Ivan and his lot won't change I'm afraid. If you want real change folks change yourselves

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  • I think its a great idea too Ivan, because in the last 18 months I've made nearly 50k from these stupid 7 days pilots seeing patients with minor self limiting crap who didn't need to see a Dr at all. It was stress free, well paid, and I put it all through my limited company to save nhs ponzi scheme charges. Long may it continue.

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  • What do people do if they need to see accountant/lawyer/dentist etc ?? they make the time and go and see when the office is open almost exclusively in normal hours... why not health or is it not that important to the populace?? If not why are we bothering???? Is my professional time worthless??

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  • 'Ivan the troll' continues to spin the 24/7 supermarket approach to GP.

    If the future of General Practice is so bright WHY don't you become GP partner and put your money where your mouth is? No, thought not.

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  • Dear All,
    So £750M for 10,000 practices, thats £75,000 each per year, thats £1,442 each per week, thats £36 per hour for each extra hour they are supposed to be open, thats to pay for the heating, lighting, cleaning, servicing, upkeep, the receptionist and the doctor. £36 per hour.
    Regards
    Paul C

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  • On the contrary, there may be enough GPs depending on the level of funding. Alliances and Federations with more than 30,000 would be in a position to put one GP from their combined manpower on a rota to cover weekends. Just one GP working would allow to avail of massive funding for full cover. It's like the APMS who were given 2.5 million worth contracts and employed a locum and a nurse practitioner to provide cover 8-8 while ordinary GP Surgeries struggled with 4000 patients on lists for just a paltry 260,000 annual payment for cover with a 8% deduction for OOH cover by walk in centres.
    Small and average sized GP Practices were never offered that sort of money, it has always been for the big boys. It's no great deal to get a locum to provide OOH cover or to put one GP on a 3-4 weeksly rota- funding remains the main factor. Would be interesting to see what happens when the PM funding stops.

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  • Indemnity costs are a major stumbling block .

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  • Vinci Ho

    (1) The game goes on. Protagonists will carry on advertising 'perfect' cliche of these schemes. We will carry on anti-spinning
    (2) Our enemy is not just Agent Hunt but more so Ozzy(you know who I refer to) and Darth Vader
    (3)No surprise to what Ozzy will say today about the spending budget. As Laura Kuenssberg from BBC news analysed and wrote ,' Each cut will be analysed in public, just as it has in recent weeks been argued over in private.
    And with each saving comes a political risk'. Ozzy's obsession to reach surplus by 2020 (with the sole priority on infrastructure construction pushing GDP up) will take the whole mentality of running public sector , hence NHS, to an unknown territory.......

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  • 1. Sundays won't get the uptake. Evening and Saturday clinics have fallen by the wayside in OP AHP clinics due to poor up-take in the past. Imaging up-take on Sundays does seem to work. Looks like patients will attend appt's that are limited in time and thinking, but with consultations they want proper week days.
    2. Beware of ISTC-style goings ons here. If GPs don't make this work, you can bet the private sector are waiting in the wings to divert NHS cash away from the already-set up practices. ISTCs were a clever way of wasting money whilst ensuring the public didn't notice further privatisation.
    3. 7/7 surgeries are not for the benefit of the patient. There are a number of other ways to ensure patients can be seen any time. This is about employers. I have noticed a reduction in the numbers of patients being allowed paid (or any) time from work for appt's. A growing number feeling so work-insecure, they daren't even mention ill-health.
    In conclusion - GPs are being set up

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  • Harry Longman

    We beg them to get evidence to inform policy. Then when eventually they get evidence, they do the opposite of what it shows. You could not make this up.

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  • Is this funding able to backfill weekday cover as staff are not now available to provide continuity of care, because they are now having to cover week-end shifts?

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  • And now for some more unintended consequences....

    1. If we have full 7/7/ services, then once non-retail industry realises this, without exception, they will be saying to their workers 'You may NOT have time off to see the doctor in working hours. Go at the weekend.'

    2.Weekend surgeries will increasingly fill up with patients who are in work, so they will get busy, on both days, to cater for the 'in-work demand'.

    3.GPs will have to have time off, so the only alternative will be during the week, so less routine work will be done then.

    4. This is very family-unfriendly and will reduce the willingness of doctors with families to commit to general practice.

    5. The net result will be a shift from weekday working to weekend working; a reduction in availability of GPs during the week; and a huge reduction in GP numbers overall.

    The shift from weekday working to full-time weekend working under the pressure of demand from patients in full-time, non-shift work is the one that intrigues me the most, because it hasn't yet been thought through properly - though non-retail businesses will certainly love it!

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