GP out-of-hours providers have been left struggling to fill their rotas because of weekend GP access schemes set up by commissioners to handle winter demand that have continued throughout the year.
West Yorkshire OOH provider Local Care Direct has been unable to compete with wages offered by GP federation Curo Health, which was commissioned as part of the ‘winter pressures’ fund set up by NHS England, and has had to turn to agency staff to continue providing services.
This comes as the workforce crisis for out-of-hours GP care has seen providers unable to cover up to a quarter of shifts in some areas, while other areas are using parademics to undertake home visits.
This has partly come about due to spiralling indemnity fees for OOH GPs, which have seen GPs quoted as much as £30,000 for annual cover.
Minutes from NHS North Kirklees CCG state that: ‘LCD have informed commissioners about the increased difficulty they have in recruiting clinicians, particularly GPs to cover both PCC [Primary Care Centre] sessions and mobile working [home visits].
‘This has been in part due to the extended hours schemes that have been run in primary care over the winter period and into 2015/2016. The significant minority of these schemes pay at a higher level than LCD are able to offer and as a result have struggled to fully staff their centres.’
The minutes add: ‘Mitigating actions include an increased use of agency doctors, increasing the rate paid to general practitioners and the reallocation of resources to centres that may be at risk of closure at short notice.’
The CCG told Pulse that they had commissioned local GP federation, Curo Health, to provide urgent GP appointments on weekends.
The scheme, launched to cover the winter period in October last year then extended through to September 2015, allows locally registered patients to call the helpline on a Saturday or Sunday morning, where they will be triaged and, if urgent, offered a GP appointment at a local urgent health centre.
When announcing the extension of the scheme, North Kirklees CCG chair Dr David Kelly said: ‘The service is helping to relieve pressure on weekday appointments as well as providing an alternative to patients who might otherwise go to A&E.
‘The original idea was to help with high demand for appointments during the winter months but we’ve now decided to keep the service going.’
Pulse has reported that the ‘winter pressures’ fund has previously attracted criticism, with commissioners using funds to maintain services as a result of ‘political pressures’.
A spokesperson for Yorkshire Ambulance Service, who subcontracted out of hours care to LCD, said that minimum staffing levels had not been breached despite the pressure on GP workforce.
