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Independents' Day

GPs must be consulted on 12-hour opening

When our CCG ploughed ahead with an 8am-8pm scheme we had to protest, writes Dr Ivan Camphor

GPs in my area breathed a sigh of relief last month after convincing our CCG not to make us earn back lost income by working seven-day weeks.

Thanks to our campaign, NHS Wirral CCG ditched plans to roll out a £3m ‘Primary Care Access Scheme’, which was part-funded by £1.4m worth of decommissioned LESs.

Wirral CCG controversially decided to roll out its Primary Care Access scheme (PCAS) for 8am-8 pm working, seven days a week, at a cost of approximately £3 million.

The potential loss of £1.6 million from the local health economy because of the decommissioning of established LES’s, threatened to destabilise practices as well as disrupt the excellent patient care these enhanced services provided. Local GPs were worried: they had has no effective consultation with the CCG about the new scheme.

Only 250 out of our 300,000 patients had been surveyed about the scheme and neither questions and statistical analysis, met acceptable standards for such a huge scheme. No quality impact assessment had been done or communicated prior to the decommissioning of the Local Enhanced Services, and worst of all there was no evidence of benefit to patients or to the Wirral health economy as a whole.

With this transfer of in-hours practice funding to extended hours, it seemed that the CCG was expecting an already overburdened general practice to provide extra services over 7 days effectively without any new investment – for free.

A survey by the local LMC had a massive and unprecedented response. The survey found that GPs were concerned that they were being asked by their CCG to provide 7 day care, which has no contractual basis and which they felt unable to provide given the funding proposals, issues with recruitment and retention of GPs, and the increasing demands of their in-hours care.

By contract, CCGs in the surrounding areas have employed different measures to improve patient access and are investing heavily in core hours access.

In an LMC meeting, it became apparent that the CCG lacked the support of the majority of the GPs present, with respect to the both the proposal and the lack of prior engagement with GPs in both their commissioning and provider roles.

Member organisation?

After delaying the rollout, which had been scheduled for April, the CCG has now said it has ‘no plans’ to go ahead with the scheme.

The CCG was apologetic and recognised the fact that GPs were unhappy. But I had to remind them again that this is a member organisation, they are representing us, not the other way around. It is not the bad old days of the PCTs when they told us what to do.

I have always been a huge admirer of the Lansley ideology ‘No decision about me, without me’. But in this instance, Wirral CCG failed to adhere to this.

Episodes like these highlight the importance of the LMC in representing GPs (both commissioners and providers), as well as fundamental issues of communication and engagement between patients, GPs, and the CCG.

Dr Ivan Camphor is a GP in the Wirral, and medical secretary of Mid-Mersey LMC.

Readers' comments (3)

  • I have made a discovery, GP's are just men and women like everyone else, they don't have the ability to work 24/7, they do have families that need and are entitled to their support, they do need sleep, they need time to recharge their batteries, and one in GP working 12 hours shifts 7 days a week does not work out!

    The government have promised patients the earth, but are struggling to deliver the basics simply because they don't have the resources to do that. If GP's fail to deliver the government will close down small practices because it likes to be bossy and get its own way, but fail to understand that the loss of just one GP has a vast impact on the community at large.

    Winning the support of GP's is not done by constantly battering them, criticising every single thing they do, making them accountable every small task they do, it is ridiculous. GP's trained for many years, are much more skilled than many pen pushers in the government, who have't a clue what a GP does during one shift, let alone one week.

    We should all learn to show much more respect fro GP's and their skills, value their professionalism and stop treating them like naughty school children!

    My GP's works 60 plus hours per week, as a patient it does cause me concern re how he / she copes, and can see the toll all this GP bashing is having on them.

    The government need to be honest with patients and admit all their wishes cannot be met, the resources just aren't there, and they go it wrong!

    Expecting anyone in government to be honest is a bit like expecting GP's to work 24/7, absolutely impossible!

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  • Vinci Ho

    No decision about me, without me.
    Yes. A very nice political rhetoric but did the person who said this actually believe that was the reality?
    Mao once said , fly the red flag but actually is against the red flag.........

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  • total disgrace.. a ccg should even suggest this..ccg's are gp led and not unaccountable pct's..i think the members should have a revolution and dismiss every single gp member who made this suggestion.a disgrace that any ccg should attempt such a massive change without extensive consultation and formal informed is unacceptable to use the old disingenuous technique that 'decisions have to be made quickly' the old devious way of pct's to enforce undemocratic diktat.

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