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GPs buried under trusts' workload dump

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)

  • '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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