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Ambulance trust cuts out-of-hours GP winter shifts due to summer overspend

Exclusive The ambulance trust running the GP out-of-hours services in Dorset is reducing the number of doctors on shift over winter after overspending its budget earlier in the year.

GPs working for the service operated by the South Western Ambulance Service NHS Foundation Trust were informed of the decision in a letter received last month.

It said the decision to reduce staffing would affect the time period from 19 November until the end of March, with GPs already booked onto cancelled shifts advised to check if they could move to another shift.

The letter said: 'The service currently is financially challenged, one of the reasons being the high number of incentive shifts we had to offer in the earlier part of this financial year, with particular focus on times where we felt we needed to bolster clinical resourcing. To rectify this we need to take a considered approach on how we can fund this gap.

'The service has been operating for a number of years with an operating model which has exceeded the budget. Unsurprisingly, the deficit that this has generated has been subsidised through other areas of the Trust’s finances. For this reason we have formalised a financial recovery plan and part of this is reducing some GP clinical shifts from 19 November 2018 to 31 March 2019.'

The letter said the service would keep the cancelled shifts 'under close review', and that 'if any particular shift is causing an issue we can review this'.

However, Pulse is told GPs working in the service believe the new shift pattern will lead to understaffing and patients being adversely affected.

A GP who wished to remain anonymous claimed it had already meant patients phoning 111 were waiting up to 18 hours for a call back with advice from an out-of-hours GP.

The GP told Pulse that - having handed out incentives to fill shifts this summer - the out-of-hours provider was now 'cancelling huge swathes of shifts'. They highlighted that this comes 'at a very odd time', with the winter season just beginning.

The GP said: 'They have cut down on GP numbers working overnight during the week and halved the cover on a Friday night, which I am just terrified about. Weekends are usually horrendous in the winter.

'We are all horrified at what it's going to potentially mean for the patients in Dorset.'

A spokesperson for the South Western Ambulance Service NHS Foundation Trust told Pulse: 'Our patients are always our top priority. In order to provide the best service we can, we have reviewed the GP shifts across the Dorset out-of-hours service. This has resulted in those shifts with little or no patient activity being removed.'

He said this comes as the out-of-hours service had 'experienced difficulty in filling some of the key GP shifts over recent months' but said it was 'expected that removing some of the quietest shifts will make it easier to fill the busiest shifts with our GP colleagues'.

The spokesperson said that the situation would be 'kept under constant review', adding: 'As well as helping to cover our busiest shifts, the removal of those under-utilised shifts will enable us to manage our budget and our resources to best effect. 

'These changes have been made to ensure that the service is within budget at the end of the financial year.'

Readers' comments (11)

  • "Our patients are always our top priority" This is the mantra of every part of the failing NHS, mismanaged by administrators who assume the title manager, believing in their own accountancy led approach rather than allowing clinicians to design a service which is fit for service by putting the patient first. We have seen the results of the expensive and ineffective triage systems. The number of persons a patient has to see and talk to: NHS 111, Paramedics, Urgent care centres ets before hours later they get to see someone who actually knows any medicine. How did we get to this state of imminent collapse of the NHS? Comments on a post card

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  • Vinci Ho

    Thanks to Lord Vader ( by the way , where us he these days?) and his Chancellor Ozzy ( I know where he is !) who created NHS111 and turned off the tap of resources to out of hour service providers!

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  • If you are a GP thinking of working the shifts there should you think again? Are you going to be dumped in very difficult situations with no back up or support if it all goes pear shaped?

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  • David Banner

    With the over 65 flu farce, there is a high chance that this Winter could be the worst in decades. Glad to see the NHS is geared up for this inevitable and preventable disaster.....

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  • Not sure why any sane GP would do OOH anymore

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  • Don't forget Gross Negligence Manslaughter for helping out is just round the corner. It does not matter if it is too busy. That is not taken into account nor your goodwill in helping and sweating it out under the pressure.

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  • Rogue1

    That's a great way to help with the winter pressures!?!?

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  • I suppose its time for the trust to ask for crisis funding, reintroduce 50% of cancelled shifts and pocket the difference.

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  • Frankly speaking:

    the REAL reason they are cutting back shifts is because they have lost the contract after March'19... the incentives they offered earlier in the year were no different from previous years.

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  • Summer is the new winter. Black alert is the new red. Flashing blue lights is now obsolete? But don't worry £3.5Bn is now allocated to Community care teams, the PM said so. Only our Regional primary care director knows nothing about it...

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