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Independents' Day

GPs given £100 an hour to provide weekend access

GPs involved in a seven day access pilot scheme are being paid £100 an hour to see patients in the evenings and at weekends.

Dr Gurdip Hear, a senior GP partner at the Crosby House Surgery in Slough, told Pulse that the hourly rate of £100 had been agreed between Slough CCG and local GPs as a ‘reasonable ballpark figure’ for the costs of providing GP services up until 8pm, seven days a week.

Funding for the extended hours scheme comes from the Prime Minister’s Challenge Fund, a £50m pot that is being used to pay for pilots of seven-day GP access in 20 areas across England. Practices participating in these pilots have been awarded money to make their services more accessible, which in most cases involves providing GP services from 8am to 8pm, seven days a week.

Slough’s pilot scheme, ‘Steps to the Future’, was awarded £2,950,000 to provide both pre-booked appointments and drop-in services from 8am to 8pm every day of the week, as well as a text-messaging service and sessions in local schools led by GPs or practice nurses. The 16 practices involved in the pilot scheme have committed to providing extra 48,000 appointments per year via four clusters in different parts of Slough.

One practice, the Upton Medical Partnership, declined to take part in the pilot citing overwork during core hours as a reason, but the pilot is fully manned during all extended hour shifts.

Dr Hear said: ‘I’m doing 12 hours this weekend, and my wife’s not happy - but as a result I’ve booked myself a holiday to Spain in half term, because I need to spend some time with the kids and this is one way of forcing myself to go.’

But GP leaders have warned that the Government’s significant initial investment in extended hours may be at the expense of existing out-of-hours services.

Dr John Rawlinson, chair of Berkshire LMC, told Pulse that it was ‘difficult to see the difference’ between extended hours and ‘a better-run out of hours service’. 

He added: ‘If a doctor is working Monday to Friday, and then there’s a request for them to work Saturday and Sunday - shifts that are already covered by out of hours - you have to remember that seven-day working comes with millions of pounds of investment. Which shift would you choose?’

If re-elected, Prime Minister David Cameron has vowed to roll out seven day working across the whole of England, pledging £400m per year over five years in ‘set-up costs’.

GPs have reacted angrily, with over 100 signing an open letter to Mr Cameron demanding that the PM ‘do the maths’. The letter explains that the extended hours pilots have failed to deliver reduced A&E attendances, and in many areas have yet to begin.

Signatories to the Resiliant GP group’s letter said: ‘You have pledged an extra £100m for this increase in hours. This equates to 1.1% increase in primary care funding for a 60% increase in workload. Do the maths, as your advisors obviously can’t. Forget the rhetoric and the arguments about doctor salaries, this fairy tale is simply not deliverable.’

Readers' comments (43)

  • I did my 10 years alternate weekends on call as a junior GP partner - never again. gPs are humans too though big pay figure may make us seem like monsters to the lower paid - we still need to sleep relax play sports socialise and see our families, no money is worth missing all that for and just feeds the rise in demand. No wonder 4 out of the last 10 GPs I've appraised are taking early retirement. Did anyone stop to look at the feasibility of this idea before throwing huge sums of money at it? Or didn't it matter, seeing as it's only a meaningless election prop?

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  • 100 pound an hour should be minimum pay noy weekend pay. Why do we work for such inadequate remuneration. After all we have worked hard and trained long to become highly skilled professionals and 100 pounds an hour seems like a carrot. As a previous commentor said, their solicitor charges 300. All NHS staff are underpaid and undervalued

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  • In most countries people accept that if you work hard and become a doctor you can expect to be well paid and they have no problem with that. They feel doctors are worth what they are paid and they respect them and the advice they give. There is also very little interest in what they do, how the hospitals are run and their practices are not constantly interfered with.
    Why in this country is the opposite true. Doscors esp GPs should be worked to the bone but not paid well and everything they do should be constantly scrutinised and micro-managed so that they have no clinical freedom to taylor treatment to the individual patient. Furthermore why is everyone so interested. Why is the public only happy when we are miserable and downtrodden.
    I don't hear outcry for solicitors and accountants earning 750k a year?

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  • Una Coales. Retired NHS GP.

    Please NHS GPs wake up and take a big dose of self esteem. The Labour government has infiltrated the BMA; the deputy Chair was shortlisted as a Labour candidate for the Heywood and Middleton by-election.

    A past RCGP chair has joined NHS England in London and NHSE is doing GPs no favours.

    Another past RCGP chair is now head of CQC, an org which is the bane of many GP partners.

    I predict APMS may entice GP partners and newly qualifieds with stable salaries of £78k as partnerships fold and then pull the rug out at a later time and drop your pay but increase workload. Just look to America and see how the salaried GP model works and has left many trapped on an assembly-line.

    There is a way out. Dr Pamela Wible MD is trying to emancipate 'enslaved' assembly-line salaried family physicians and show them how to set up independent practices across America, and I have seen how a private (Independent Doctors Federation member) GP works in Chelsea runs her own practice with a secretary and nurse and say, this is the way forward. IDF got all their private GP surgeries through CQC checks years before CQC came after NHS GP partners! IDF reported private medical insurance companies to the competition commissioner when they tried to cut out private GPs and reduced PMI reimbursements for semiprivate NHS/privafe consultants. I know as I was GP chair at the time thinking we could 'negotiate' with PMIs. It needed a male GP head of IDF to take action and take out the big guns!

    IDF is like a trade union, college, support group, and revalidation body (with their own RO and GP appraisors, including one for those with portfolio careers too like military/occu health etc) all in one doctor-led org of semiprivate hospital consultants, portfolio NHS/private GPs and private GPs for just £250/year.

    Many young London-based female portfolio NHS /private GPs are now members of IDF. It is the future to save general practice.

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  • Una Coales. Retired NHS GP.

    PS. The reason why many US salaried family physicians may be suicidal is because they may be working in assembly-line medicine, in a stressful profits before patients climate, barely paid a living wage, with the constant daily headache of figuring out how to repay their 6-figure medical student loans and stay financially afloat for their families. This future may be headed for UK general practice and I am trying to prevent a life of misery for our younger GPs.

    £100/h to open a surgery outside of normal opening hours will not cover practice overheads and staff pay. How many rules and burdens do you need to be forced to comply with, before you realise you have no rights under this oppressive uniateral NHS state GP contract?

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  • Una Coales. Retired NHS GP.

    In 1952, private Chelsea GP Dr John Hunt and an Australia GP set up the RCGP as a college to support GPs, like a supper club of intellects gathering around a dinner table or sitting in a library exchanging ideas. Dr Hunt donated huge sums from his own private practice income to help fund the college premise, Princes Gate and lobbied Parliament to get a charter recognised.

    The College evolved as NHS GPs outnumbered private GPs and a few years ago, as Council rep, I fought to ensure private GP members could apply for FRCGP as the rules at the time stated one had to be on the NHS performer's list. Before long, the College became more of an org for NHS GPs than private.

    Private GPs decided to set up their own 'college' and called it initially the 'Independent Doctors Forum' and encouraged monthly suppers with semiprivate consultants and GPs alike meeting at the Royal Society of Medicine. Private Sloane Street GP Dr Jonathan Hunt, son of Dr John Hunt, became a member of IDF. His father might have turned in his grave to see how the College he had helped to found had changed to one 'putting patients first' above the wellbeing of GPs.

    It is nice to remember where general practice started in this country. It was always private independent practitioners until they were lured into working for the NHS state...and now have the rug pulled from under them and have forgotten how to be private, independent practitioners...

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  • With GPs numbers dwindling to PCTs removing them off performers list for unjustifiable reasons of not listening to their non cost effective measures.Their measure had had been shown by a number of specialists to be counter productive.They will be less doctors to treat an increasing ailing populaion irrespective of what you now pay them

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  • I love reading your posts Una, I always learn so much from them.
    I don't know enough about the history of General Practice, so this is probably an uninformed question.
    Didn't people have to pay to see a doctor before the NHS? And didn't this disadvantage poor people? The Guardian did a fascinating series of articles written by a man who told his experiences (pretty harrowing, lots on infant mortality and pauper's burials) before the NHS. Or did doctors do charity work? Who cared for the poor pre 1948?

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  • Please, please, please let us all just say 'no'. If we all refuse 7 day working for routine care we have a chance. General practice was never part of the emergency services so why routine care is suddenly considered essential seven days a week, I don't know.
    Would it not be a hell of a lot simpler and more cost effective for businesses to allow employees time off for appointments?

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  • Anonymous | Other healthcare professional | 14 October 2014 12:51pm

    Harry's Last Stand by Harry Leslie Smith.
    Read it and weep!

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