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Gold, incentives and meh

PM's seven-day access drive extended to 1,400 more GP practices

The Prime Minister’s drive to extend GP access has been extended today, with a further 37 bids approved, covering more than 1,400 practices.

The practices will be given a share of an additional £100m to extend access to GP practices at evenings and weekends.

One bid from 87 Sheffield GP practices has been granted funding worth £9m, and will see seven-day GP access in five sites across the city.

Another successful bid from Tower Hamlets will see four GP ‘hubs’ across the borough will provide 8am-8pm access seven days a week and pharmacist training to offer more prescriptions.

Elsewhere, a scheme in Manchester – where seven-day opening was pioneered – has been given funding worth £5.4m, to cover 92 practices.

This is the second tranche of funding from the Prime Minister’s ‘Challenge Fund’, which is aimed to improve access to GPs on evenings and weekends and improve the use of technology, and follows the first tranche that invested £50m.

The bids will be for funding over 12 months, and successful bids have come in from all over the country.

The most recent investment, announced during the Conservative Party conference in September, came after Pulse revealed that many of first group of pilots had yet to begin in September last year, despite funding being due to end in April.

As a result, NHS England said in February it will extend funding for the pilots to allow ‘fuller analysis’, after admitting that there was insufficient data to measure the success of the scheme ten months into the year-long pilots.

The additional funding comes as NHS managers in London have begun talks to create routine GP Saturday opening in London.

Dr Chaand Nagpaul, chair of the GPC, said: ‘It’s vital that this new money is used in ways that meet the needs of patients, and to support practices to ease the pressures on GPs struggling to cope with escalating patient demand. There was evidence from the first wave of pilots that despite low demand for appointments, NHS resources were being spent on keeping some practices open on Sundays.

‘Going forward, we must allow pilot sites to implement their funding allocation flexibly and make necessary changes to plans or services to ensure appropriate use of the resources provided.’

He added that the BMA ‘remains concerned’ that the funding is for only a year, and practices will not have resources to continue any successful initiatives.

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Readers' comments (28)

  • The problem with these schemes is that they are only funded for one year. Post-election, when the evidence for cost saving is weak and CCGs don't want to fund them... then what? I hope whichever government is in power realises that primary care must receive greater funding in return for increased capacity - however this is achieved.

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  • Isn't it about time we fix access in hours when most of us are working flat out and most of the patients require proper help, we have no capacity or desire to work more hours.
    In hours medicine with all the support services in place is good medicine; my Saturdays are next to useless as a lot have to come back for other services duplicating trips for the patient. As Bob G said give us the ........ money and you'll find an improved service. This may have more GPs with more time to sort things properly,educate patients, support them early- chucking money at extended hours services will be throwing it away in terms of efficiency and cost/ patient.
    I personally am seeing 40-50 a day the demand cannot be matched in hours and if I have to work Sat/Sun I'll not be in in the week when I'm already flat out.

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  • Practice - "Dear Mr Hunt. The project was a success! We saw another 1 million patients and they were all delighted. Can we have our funding carried forward please?"

    Mr Hunt - "Sure. It'll be in next year's QOF. If you see 2 million patients we will give you £1000"

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  • Sadly, patients don't realize what this means.

    Weekend access costs more to provide then weekdays. Even if I was happy to work at same rate (which I'm not. I already only see my family less then couple of hours/day), my reception/admin/nurses will want x1.5-2 pay. This is sacrificing money that could have been used more effectively in hours for convenience of appointment. There are no evidence increasing GP access decreases AED attendances our hospital admission.

    Is it so bad you cannot access non emergency service for 2 days in a week? Many other country don't have any free access to primary care and manage. We need to stop the dependency on health care!

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  • Ivan Benett

    This is excellent news and we will be able to develop the service further, and better integrate with the rest of the urgent care and planned care system.
    However, as earlier anon comment, this is no substitute for effective in-hours access funded through GMS contract.
    Well done Manchester GP providers. Once again Manchester leading the way

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  • this is not sustainable. throwing little lumps of money here and there for weekend opening is a sticking plaster, and unfortunately being done for the wrong reasons.
    we have no data that a&e attendances have dropped with weekend opening. as a recently qualified gp i am very close to leaving my salaried job to start locuming because of things like this.

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  • Can people not see that this is not about rational and clinically necessary use of the NHS but is political? Why should we dilute services and reduce our own quality of life (and worsen the current and imminent manpower problems) so that politicians can claim credit for some sort of "achievement". Fund routine in hours and emergency OOH properly and suggest that patients use the free-at-the-point of need service responsibly. One could always add a pay-per-consultation routine evening and weekend service for those who want even more than I imagine private GPs provide (in terms of opening hours) so that those most in need do not have their service undermined and down-graded.

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  • Vinci Ho

    Typically the PM spoke about the subject of 7 days opening in his party spring forum typically in Manchester . BBC analysis was a fair one:
    Analysis
    By Ben Wright, BBC political correspondent
    This spring forum is about fighting back against Labour on the NHS.
    Polls show a clear, large consistent lead for Ed Miliband's party on the NHS. It is the foundation stone of Labour's campaign.
    But the Conservatives are desperate to chip away at it with promises of protected real-terms increases in funding and an extra £2bn a year.
    The Conservatives are committing to providing full weekend hospital care in England - in line with the NHS's own five-year plan.
    The big question of course is, "Where will the money come from?", but this is about politics.
    This is an attempt to try to neutralise the NHS and enable the Conservatives to return to what they want to be talking about - the economy.

    Yes. It is about politics.....

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  • Vinci Ho

    Dedicate this song , one of my all time favourites, to those who 'strongly' believe what they believe. Please at least be honest to yourself:
    Honesty - Billy Joey
    If you search for tenderness
    It isn't hard to find
    You can have the love you need to live
    But if you look for truthfulness
    You might just as well be blind
    It always seems to be so hard to give

    Honesty is such a lonely word
    Everyone is so untrue
    Honesty is hardly ever heard
    And mostly what I need from you

    I can always find someone
    To say they sympathize
    If I wear my heart out on my sleeve
    But I don't want some pretty face
    To tell me pretty lies
    All I want is someone to believe

    Honesty is such a lonely word
    Everyone is so untrue
    Honesty is hardly ever heard
    And mostly what I need from you

    I can find a lover
    I can find a friend
    I can have security
    Until the bitter end
    Anyone can comfort me
    With promises again
    I know, I know

    When I'm deep inside of me
    Don't be too concerned
    I won't ask for nothin' while I'm gone
    But when I want sincerity
    Tell me where else can I turn
    Cause you're the one that I depend upon

    Honesty is such a lonely word
    Everyone is so untrue
    Honesty is hardly ever heard
    And mostly what I need from you

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  • i think both parties are promising 7 day a week NHS services so it will happen. I don't think there will be new money but it's likely that in order to maintain current funding you will have to offer the service. If you don't you just won't get the money. let's wait and see.

    I'd love to know what Ivan thinks about 24 hr service - which i think will be next on the agenda. It will be a challenge for you to provide with no new staff or funding?

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  • Ivan Benett

    Thanks Anon 29th March 11.51pm - I wish I knew who you were - email me ivan.benett@nhs.net
    The drive for 7 day working in hospital is the shameful increased mortality at the weekend. There isn't the same drive for access to Primary Care. For most of the weekend I think the current OOH service does the job to manage urgent care demand during those times - they could be improved considerably by working closer with in-hours service, in particular sharing records
    However, there is a driver to offering an extended hours service during the week and for some hours at weekends. The provision should eventually be a full Primary Care service for proactive as well as urgent care need. This is for people who can't access in-hours service due to work, or other commitments. The demonstrator sites seem to show a demand for some opening on Saturdays, but a lesser demand on Sundays at the moment. I think when people get used to the idea it will become like Sunday shopping and more people will use the service. I'm afraid the consumerist genie is out of the bottle.
    The other benefits of longer opening are that we can minimise the chance of missing serious disease and unmet need.
    Furthermore, in contrast to much of the speculation, extending hours should increase the chances of relational continuity, as urgent care will be managed in a better way. Patients should be better able to see their 'own' GP during normal hours as there will be less pressure for urgent appointments.
    The workforce issue is real. However, if we know what we're going for we can plan for it. There is no doubt we need many more GPs and a much expanded Primary Care nursing workforce. Our experience in Manchester is that younger doctors prefer the flexibility. At least one doctor working for the GP provider in the evenings trained in our practice. She has just had a baby, and is able to work the evening sessions when her husband gets back from his in-hours work. She doesn't want a partnership and this role ticks many boxes for her.
    Another objection I hear, especially in these comments columns, is that some of you don't want to work late in evenings or at weekends. Well you won't have to, others will do it, if we plan correctly.There is, nor will be, any compulsion for individuals or individual practices to open extended hours. A federated model will and does work.
    Resourceing the extra service is a real issue too, from which I would not hide. There is, nor is likely, to be extra resources recurrently. However, a huge resource is being wasted by unnecessary hospital activity right now, and much other waste in the system. If we could identify and harness that resource we could easily fund the extended hours services across the country. I'd need more space to expand on this, but medicines management, avoidable unplanned admissions, unnecessary referrals, more proactive primary care (which the extended capacity in time and workforce will allow) could all go towards finding and redirecting current NHS funds into Primary Care. That's why I've always said that everyone's a winner.
    Together with expanded primary care and a smaller secondary care, we need new ways of working. This cannot be delivered by small individual practices working in isolation. There are new ways of working to provide both urgent and planned Primary Care. Those who see this will prosper, those who don't will wither.
    I'd love to have more space and time to go into detail...but I must get off to work. If Pulse wish to commission an article, I'd be happy to oblige

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  • Ivan Benett | Salaried GP | 28 March 2015 11:51am

    1 thing is simple, most GPs don't want to be forced to work weekends, whatever the money, and for political reasons, so you can see all the patients thx

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  • Re: Ivan Bennett's comment - apart from the fact that Central Manchester PCM are now begging for GPs to cover the shifts...

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  • Ivan Benet, what a breath of fresh air you are.

    It makes such a change to read such positivity, compared to the usual negative moaning that usually goes on on this forum.

    Everybody seems to moan about the current form of General Practice, most don't make any recommendations to improve other than to "put more money in my pocket" and all bar none complain at every suggestion put forward to improve what we offer.

    I would love to work in an environment with someone so positive as Dr Benett, there is so much control we could take back if we just grabbed the high ground by being proactive in introducing the required change to General Practice instead of just waiting for others to make the suggestions and then moaning about it!!

    Good Luck to all those positive General Practice's in Manchester, I hope you achieve the success you rightly pursue.

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  • Anonymous | NHS Manager | 30 March 2015 11:00am
    "put more money in my pocket"

    We don't want the money, and we have suggested LOTS to improve GPland - get rid of overregulation, non-clinical work, CQC/GMC/QOF/revalidation, crown indemnity, reduce public demand, etc. in every article on here. but either you're criminally ignoring what grassroots GPs say, or you read, but none of it goes in

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  • Good luck to Manchester- nail down these 24/7/365 contracts before your budget is devolved to Health and Wellbeing boards under local authority control, then watch the drain away from healthcare spending to plug the social care gaps.

    And as for more money to the GP pocket- sh!t sandwiches never taste nice but the more bread there is, the easier it is to swallow; however like ohers on here reducing the amount of sh!t is more on our agenda than more bread!

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  • Ivan Benett

    Thanks
    Anonymous | NHS Manager | 30 March 2015 11:00am
    'Ivan Benet, what a breath of fresh air you are. It makes such a change to read such positivity, compared to the usual negative moaning that usually goes on on this forum.'
    I appreciate it. The rest, please email mail me with your specific concerns and I will try to allay them. ivan.benett@nhs.net

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  • Anonymous | GP Partner | 30 March 2015 12:51pm

    That you Copperfield? lol the concerns Ivan? How would you address the fact that nobody wants to work weekends? Force them to by dangling some money, then taking it away after a year right? We're not stupid

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  • Vinci Ho

    Politics is such a wonderful game , isn't it?
    Fans of Game of Thrones, 5th season is coming in April .Totally unmissable.

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  • Ivan Benett

    Hi Anonymous | Salaried GP | 30 March 2015 2:03pm
    Anonymous | GP Partner | 30 March 2015 12:51pm

    'That you Copperfield? lol the concerns Ivan? How would you address the fact that nobody wants to work weekends? Force them to by dangling some money, then taking it away after a year right? We're not stupid'

    People do want to work at weekends, especially if it means they can be flexible. It's a fair wage for fair work, and no one can force you to do anything...

    As for being stupid, as I don't know who you are I can't tell. Why not email me?

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