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A faulty production line

CCGs prepare to step in to fund GP seven-day opening pilot when Government scheme ends

Exclusive CCGs are already looking at ways of continuing to support the Government’s agenda of extended access for patients when central funding runs out next year, Pulse has learned.

It comes as NHS England would not commit to funding the 20 schemes announced by prime minister David Cameron this week beyond ‘one year’. The scheme will see more than 1,000 pilot GP practices offering extended opening in evenings and at weekends, and trialling things like 24-hour telephone access, email and Skype consulations, to some 700,000 patients, with central funding supplied up until 1 April 2015.

An NHS England spokesperson told Pulse: ‘The funding is for one year for 2014/15, to help practices test new ways of delivering services and extending access and ensuring that services are sustainable beyond the first year. “The successful pilots have had to demonstrate that they have clear, credible plans for delivering benefits to patients on an ongoing basis, beyond the lifetime of the pilots. The programme will produce evidence based models of innovative practice and actionable learning about how best to implement them.’

NHS England head of primary care Dr David Geddes said: ‘I don’t think big central funding and bids is the best way always to get the best out of practices. So I think it would be useful to make sure… how we’re going to work with CCGs, CSUs and local area teams, to be able to help sponsor and support that kind of development as a provider.’

And some CCGs are already looking at ways of continuing to support the Government’s agenda when central funding dries up.

Dr Mark Grealy, a GP at Morecambe’s Coastal Medical Group who led the practice’s challenge fund bid, said NHS Lancashire North CCG has already signed up to funding the scheme in the long term if it can show it stems the ‘influx of elderly patients to A&E, especially at weekends’.

He said: ‘We want to ease the tremendous pressure on A&E and we will be measuring and evaluating the scheme over the next year, perhaps at the six and 12-month mark to see if there has been a decrease in A&E attendances and admission rates particular amongst this elderly population.’

‘The CCG is a crucial part of this and have already said that if we can demonstrate a saving of, £x - say £1m - for arguments sake, then they have committed that they will pay for that going forward if we can show these savings.’

In a grand unveiling of the pilot sites on Monday this week, the Department of Health said its one-off investment would support ‘forward-thinking services to suit busy lifestyles’. However, GPs warned that patients would become ‘disillussioned’ if these services do not continue beyond the pilot year.

Dr Ivan Benett, clinical director of Central Manchester CCG - where four localities rolled out extended access just before Christmas offering patients appointments until 8pm during the week and for six hours at weekends - warned that the pilot schemes could build up patient expectations and that if the CCG could not continue funding then the Government should.

He said: ‘I think there is a risk of disillusion by the public and profession alike. However, I’m confident that the extended hours will provide a better service and reduce urgent care activity so it will be self-funding.’

‘If not, I would sincerely hope that the Government continues to support these projects through local area team resourcing. As it is commissioning these services mainly from GP practices, I would expect this to be the funding route, rather than CCG funding which is mainly to commission secondary care services.’

Dr Richard Vautrey, GPC deputy chair said: ‘The first thing is to properly evaluate the various schemes. This must look at the impact of spreading the current service more thinly. Service expansion needs a workforce expansion to be sustainable.’

‘If the pilots are found to be beneficial but the necessary funding is not found to ensure they can continue, not just for the small number of practices involved but for all that want to provide similar services, then patients will consider this to be just a pre-election gimmick and not a serious policy to invest in general practice.’

NHS England is yet to appoint an independent evaluator of the scheme.

Readers' comments (20)

  • Took Early Retirement

    One year: who in their right mind would go in for this? And what services will CCGs CUT next year in order to let it's pet pilot carry on?
    CCGs are supposed to be GP-led, are they not?
    Vote these things down, or at least warn them that after a year, they are on their own and can pay the redundancy packages themselves to the staff they have hired.
    No- of course, the local GPs will be expected to fund it.

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  • Vinci Ho

    Oh ! So predictable.
    Bring in all your comments, comrades

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  • NWLT bid is based on 5 million from the fund and 4 million from the CCG and another from million from the LETB. So when they evalute it does anyone think it is going to be based on the whole sum?? Someone tell the PM his so called is being subsidised by the the grassroots. LOL

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  • There is an out of hours service for urgent cases . However people want to be able to consult at the time and place of their choosing . This is called private medicine and customers ought to be allowed to pay for this service. Unfortunately the NHS can only fund what is actually needed . If we try and comply with these unreasonable demands of politically inspired expectations then vital services will be cut . It is straight forward economics .

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  • The answer to this demand for convenience medicine is to allow NHS service providers to charge private fees for non -core hours activity . It works for consultants why not general practice ? For some reason ( probably those Jeremy Hunts at the daily mail ) the general public do not think we deserve reasonable pay and a home life .

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  • Vinci Ho

    (1) Step one : publicise a huge success of the pilot schemes with no disadvantages , hence 50 millions well spent and value for money
    (2) Step 2 : stop all MPIGs and any 'overpaid' money in PMS practices , so there will be significant loss in core funding of good number of practices
    Any existing QOF points will be cut further to fund an enhanced service called 8-8/7Ds. A loss of easy £20-30,000 of an average practice if this is rejected .
    (3)Step 3: practices are allowed to close down and CCG will launch a procurement for Any Qualified Provider(AQP) to bid these practices.
    A new order is established in general practice. Mission accomplished , well done , Agent Hunt.
    This message will self destroy in 5 seconds......

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  • so the governments useful idiots have performed their dysfunction by being bribed with gold.
    as above i agree the mendacious snake politicians after the inevitable 'success' of pandering to inappropriate wants not needs will cunningly pass the extra cost on to ccgs and so hide the dysfunctional priority so created to the harm of real needs.i so agree with the above if people wish this luxury they should pay privately.
    kings fund confirms no evidence gp contract ooh changes increased major aed demand..but demand to walk in centres and minor injury type units which is absolutely fine as this is precisely why they were set up and are successful.
    this will damage gp morale,increase early retirements and damage recruitment.
    it is purely a pre-election public relations scheme. usual dysfunctionally and ignorantly 'fixing' the previous government disastrous destruction of the previous excellent system of ooh gp such genius schemes as nhs unbelieveable disaster(still it gives me a laugh on my on-call days..this week i was amazed to read one piece of robotic verbiage rubbish report informing me that a patient with an exacerbation of chronic fibromyalgia had an emergency ambulance called for her!!!!!)
    reject out of hand this lunacy i think.

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  • When the funding runs out the service stops .

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  • Vinci Ho

    Editor , there was problem last night on this Web site last night in terms of reading the actual articles and hence leaving comments?
    Not being sabotaged??????

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  • Thanks for your feedback. We have been experiencing some difficulties with the website today, but we are back up and running as normal.

  • How many CCG members will be on the coalface of 8-8 7 days a week?

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