Trusts begin moves to extend GP hours
By Steve Nowottny
PCTs have made the first moves in a campaign to dramatically extend GP opening hours in line with recommendations in last week's landmark Government report on the future of the NHS.
Trusts are aiming to force the issue with a carrot-and-stick approach, through a mixture of local enhanced services, private provider contracts and demands for action plans from practices.
The first moves in what is expected to be a concerted campaign on access came as Lord Ara Darzi last week published the interim report of his Next Stage Review, which is set to have a huge impact on the future of general practice.
Lord Darzi said at least half of all practices must provide evening or weekend appointments within three years.
New funding will be available to reward GPs who offer longer opening. But those GPs who refuse to open longer will face financial penalties.
The report warns: 'Where existing GPs do not start to offer extended services, PCTs will be able to commission services from other GPs, GP federations or other providers.'
Dr Laurence Buckman, GPC chair, said the Government had this week opened negotiations on opening hours after months of silence.
He said the GPC still believed paying GPs for extended opening was 'a waste of taxpayers' money' – but was willing to listen to offers.
'If they offered me 25 grand a year to open for another hour a day, I might consider it. If they offer me thruppence and continue to spread stories that we're the most evil human beings on the planet, then I don't think I'll do it.'
But some PCTs have pre-empted national negotiations and already begun planning to extend opening hours.
Derby City PCT is in talks with all its providers – and has commissioned longer hours from APMS provider United Health, starting next month.
East Lancashire PCT and Leicestershire and Rutland PCT are due to launch pilot schemes on access in the next few weeks, and Hillingdon PCT is to appoint an 'access co-ordinator' to 'work intensively with practices'.
Even PCTs that scored highly on access in the Patient Experience Survey are planning to boost GP opening hours.
Sunderland Teaching PCT – where 90% of patients were satisfied with opening hours – has introduced a 'trial' LES.
Dr Deborah Russell, a local GP, said: 'It seems a bit out of step with our results. I suspect the Government will do what it wants regardless. It'll have us open 24 hours before long.'
But David Stout, director of the NHS Confederation's PCT network, said LES payments would be too expensive for some trusts, and that the Government was also likely to incentivise longer opening nationally through a revised QOF.Waiting room