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A faulty production line

Christmas closure row intensifies as practices vow to fight breach of contract notices

Exclusive GPs hit with breach of contract notices for closing over the Christmas period will dispute them, as it emerged that practices in other areas were allowed by managers to close at 4pm on Christmas Eve and New Year’s Eve.

LMC leaders in London said that 11 of the 12 London practices that NHS England has served with breach notices for closing early on Christmas Eve will dispute them.

It came as the GPC said that they would be taking the issue up with NHS England nationally, saying that managers needed to be more consistent in the way they held GPs to their contract.

NHS England’s local area team in London said that staff rang round 238 GP practices in the capital after 3.30pm on Christmas Eve to check they remained open. As a result of the calls, NHS England found that 12 practices had transferred calls to an alternative provider and has subsequently issued them with a notice that said this was ‘serious breach’ of their contract.

It repeated the same exercise on New Year’s Eve and told Pulse that further breach notices ‘have been or are in the process of being issued’.

But Londonwide LMCs claims that many of the practices were contacted when they would not normally have been open on a Tuesday, and that one practice was even contacted on the wrong telephone number.

A spokesperson said: ‘All the practices bar one that I am aware of intend to dispute the breach notices, and Londonwide LMCs are helping them to compose initial letters of response and guiding them through the process.’

They added: ‘Most of the practices contacted by Londonwide LMCs were rung by NHS England at a time when they are usually closed and using an alternative provider on Tuesdays (e.g. between morning and evening surgeries, practice half day for staff training). One practice was called by NHSE on a wrong number.’

But Pulse has learnt that in Manchester GP practices were able to divert to out-of-hours services from 4pm onwards after the area team said it would honour agreement reached with the LMC in November, despite the strongly-worded letter sent by NHS England’s head of primary care Dr David Geddes in December.

Dr John Hughes, honorary secretary at Manchester LMC, said: ‘[I am] not aware of any breach notice issues locally in Greater Manchester. We did have an agreement negotiated with [the area team] in November that they would allow practices to hand over to OOH at [4pm] both days unless excessive activity. [The Greater Manchester area team] said they would stick to this agreement despite the Geddes letter.’

LMC leaders in areas including Wessex, Birmingham and Devon were also unaware of any breach notices being serviced locally when contacted by Pulse.

The GPC said they were concerned by NHS England’s approach on the issue. GPC chair Dr Chaand Nagpaul said: ‘I will certainly be taking up this matter with NHS England. We do need to ensure there is a consistent approach. In Manchester, the area team has taken a more flexible and understanding approach and I think we need to take this up with NHS England in terms of national policy.’

He added: ‘The policy for closing at Christmas is actually quite inconsistent with policies around closing at other times during the year. Many practices will have different opening hours and it just seems very odd that the Government targeted Christmas Eve and New Year’s Eve specifically, when it is inconsistent with practices’ arrangements for the rest of the year.‘

A spokesperson for NHS England (London) said: ‘The letters sent to practices setting out the breach set out clearly what steps practices need to take if they wish to discuss the issue further. NHS England (London) remains committed to this offer.’

‘No outside resources were used in this exercise which was carried out during normal operating hours. NHS England contract managers undertook the phone exercise which was completed within 45 minutes as part of routine duties.’

A spokesperson for NHS England (Greater Manchester) said: ‘We are satisfied that GP practices retained clinical responsibility for the provision of patient care during the Christmas and New Year period, and continued to offer access to both routine and urgent care to patients. In some situations practices engaged call-handling deputising arrangements within their contractual requirements, using the usual out-of-hours providers for telephone calls.’

Related images

  • closed sign credit flickr James Cridland

Readers' comments (16)

  • It might be of interest to note that Dr Geddes's own surgery in York had handed over to another provider at 6pm on both Xmas and New Years Eve. Also their telephone lines go to answer phone every day at lunchtime for 1.5 hours(according to their website) to allow for staff training.
    Not quite sure how he squares that with the letters that have been sent by him to GP my view his position is untenable and he should resign or be sacked from his position with NHS England.

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  • I would second the call for Dr Geddes resignation. He can then try working a full week like the rest of us as a real GP.

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  • Add another.

    His overseeing of the payments fiasco makes his role untenable. He lacks the basic leadership and management skills to do the role properly. Let's see if he has the insight to do the correct thing - for the greater good of all our patients.

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  • Vinci Ho

    You see, the way it goes , organisations like NHSE , CQC will certainly pick on 'contentious ' but media-wise juicy subjects in general practice and blew it all up in public.
    Like the maggots storm in teacup , this is about forgetting common sense and go straight to political correctness to earn credits for the prosecuting

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  • Vinci Ho

    to continue:
    ....prosecuting party.
    Right or wrong, this is about having agreement for an alternative arrangement in a time when demand is expected to be low . As long as cover is provided , which OOH provider is there, there is no need to 'go on trial ' in public.
    The word is PROVOCATIVE which summaries the attitude of these politicians and bureaucrats towards GPs in this country . They like to test our bottom line of tolerance all the time now. Forget about working together , not picking a fight with GPs and the most GP friendly Health Secretary in decades.
    Ladies and gentleman , somebody somewhere is trying very hard to tell a lie over and over again, hundred times, thousand times , and hope it will become the truth ......Sorry, they do not deserve our trust.....

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  • Russell Thorpe

    I agree with Vinci Ho. We accept contract impositions, pension changes but insist we work normal hours and we become Che Guevara. Re Dr Geddes, the poor man was only following orders.

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  • Vinci Ho

    * *Do remember that dishonesty and cowardice always have to be paid for.*Don’t imagine that for years on end you can make yourself the boot-licking propagandist of the Soviet régime, or any other régime, and then suddenly return to mental decency. Once a whore, always a whore.
    George Orwell
    1/9/1944 on Warsaw uprising

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  • i think it is about time for practices to stick to working to rule. There is so much outside the contract that the majority of GP practices do and I think it needs to stop immediately. I suggest London LMC produces a leaflet saying that this is in direct response to the heavy handedness of NHS England so that patients can be given these letters when they turn away patients who want sutures removed and medicines prescribed.

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  • Peter Swinyard

    Whatever happened to the "single operating model" trumpeted by the NHS Commissioning Board Authority before it bigged itself up to being called NHS England? Oh, of course, silly me. Forgot that London is different to England.
    Our contracts have never told us to have the doors open 8am-6.30pm with a full flock of hot-and-cold running nurses, receptionists and doctors. They tell us to provide a service to our patients. Which is why some practices close in the middle of the day and have a half day. I am not saying that this is a good thing to do - my small practice has doors open 8.30-6.00 and phones on and staffed 8-6.30. However, it is still contractually sound to do so if the needs of patients are covered.
    On the personality issues here, those who live in glass houses....

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