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Greater Manchester-wide expansion of seven-day GP access planned for year end

Manchester’s seven-day working pilots are due to be significantly expanded by the end of 2015, it has emerged.

The Greater Manchester health economy, which has been handed a devolved budget for health and social care by the Treasury, is planning to fund a huge expansion of the scheme which has been led by Manchester GP Dr Ivan Benett, clinical adviser on the NHS Central Manchester CCG board.

Like in the central Manchester pilot, plans are for practices to form local hubs to jointly provide access over seven days, offering a walk-in service on weekends, Manchester Evening News reported.

However Manchester LMC honourary secretary Dr Tracey Vell, who was only recently invited to join the devolution programme board, told Pulse that this would not be achieved by extending the core hours contracted from GP practices in Greater Manchester.

Dr Vell said the LMC had successfully made the point that GPs could not expand their core contractual hours, an idea floated several times by the programme board.

She said: ‘What we’re going to provide is a separately commissioned and local access to a GP in a non-urgent way, outside of core hours. But that offer is not necessarily going to be either provided by GPs in practice, nor paid for through the core contract or anything.’

Dr Vell added: ‘It’s just for clarity, there’s been lots of confusion coming out from Manchester, I’ve been very vocal about it all along. I will not support it, the LMC and the [GP] workforce cannot support any extension. It’s not safe for patient care.’

Manchester LMC leaders, were excluded from initial discussions as plans were agreed with the Treasury, but was Dr Vell was finally accepted to join the programme board last week.

Dr Vell further revealed that plans are under discussion to roll out integration of primary, secondary and social care within local hubs covering the population of around 10 GP practices, which would see hospital specialists and social care workers spending time in the community alleviating pressure on GP practices.

Under the LMC-supported plans, these hubs could see ambulatory GPSIs provide weekly clinics for diabetes, COPD or heart failure and also allow hospital specialists to conduct outpatient appointments closer to people’s homes.

Dr Vell said: ‘Instead of running diabetic clinics in your surgery, you will run it at a local specialist centre which is local for those 10 practices. So the patients will go there and also have access to the consultant and his team as well as voluntary agencies that can help them with the social part, such as benefits.’

Readers' comments (12)

  • when the funding dries up, and this is expected to carry on (like all things in the NHS do...remember extended hours funding being cut in half...and...) what then? I would not touch this with a bargepole. on behalf of my resilient GP colleagues. The Manchester salaried GP's who love this, good luck to you. Just make sure it is known this does not have the support of normal grassroots GP's working 50 hours + a week.

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  • This sound like a crock.

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  • Hopefully they will cover Ivans practice on Wednedsay afternoons when his practice is shut.

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  • About time they got the LMC on board, too much of this has been done in secret

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  • Not wishing to appear thick, but how is this different from the current out of hours facilities-walk in centres etc.?

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  • Anon 9:16

    It isn't. Don't we, as a profession, sometimes make ourselves look bloody stupid?

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  • Vinci Ho

    Calling a Stag a Horse 指鹿為馬
    In the reign of Emperor the Second of the Qin Dynasty (221-207 B.C.), the prime minister Zhao Gao, obsessed with ambitions, was planning to usurp the throne day and night. But he did not know how many of the ministers in the court were allowed to be ordered about by him and how many of them were his opponents. So he thought out a way to test how high his prestige among the ministers was and also to find out who dared to oppose him.

    One day when court was held, Zhao Gao let someone bring a stag to the court and, with a broad smile on his face, he said to Emperor the Second of the Qin Dynasty:"Your Majesty, here is a fine horse I'm presenting to you." Looking at the animal, Emperor the Second thought that it was obviously a stag and that it couldn't be a horse. So he said smilingly to Zhao Gao:"Mister Prime Minister, you are wrong. This is a stay. Why do you say it is a horse?" Remaining calm, Zhao Gao said:"Will your Majesty please see more clearly? This really is a horse that covers a thousand li a day." Filled with suspicion, Emperor the Second looked at the stag again and said:"How can the antlers be grown on the head of a horse?" Turning around and pointing his finger at the ministers, Zhao Gao said in a loud voice:"if our Majesty do not believe me, you can ask the ministers."

    The nonsense of Zhao Gao made the ministers totally at a lose, and they whispered to themselves: What tricks was Zhao Gao playing? Was it not obvious whether it was a stag or a horse? But when they saw the sinister smile on Zhao Gao's face and his two rolling eyes which were gazing at each of them, they suddenly understood his evil intentions.
    Some of the ministers who were timid and yet had a sense of righteousness did not dare to say anything, because to tell lies would make their conscience uneasy and to tell the truth would mean that they would be persecuted by Zhao Gao later. Some ministers with a sense of justice persisted that it was a stag and not a horse. There were still some crafty and fawning ministers who followed Zhao Gao closely in ordinary times. They immediately voiced their support to Zhao Gao, saying to the emperor:"This really in a horse that covers a thousand miles a day."

    After the event, Zhao Gao punished by various means those ministers with a sense of justice who were not obedient to him, even with whole families of some of those ministers executed.

    This story appears in "The Life of the First Emperor of the Qin Dynasty" in The Historical Records written by Sima Qian. From this story people have derived the set phrase "calling a stag a horse" to mean deliberately misrepresenting some thing and misleading the public.

    Who is our Zhao Gao?

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  • "which would see hospital specialists and social care workers spending time in the community alleviating pressure on GP practices."

    History tells us that this will NOT alleviate pressure on GP practices because most of the community visits usually result in "Better book an appointment with your GP" advice. Thus adding to the pressure on GP appointments.

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  • @Anon 9:16 am and 1:18pm

    It is different to out of hours as this is for routine care, not just urgent care. It differs from walk in centres as most of the appointments in this service have to be pre-booked by the registered practice. It is primarily about offering convenience to patients rather than dealing with anything that is clinically urgent. Practices can receive a call from one of their patients during core hours but book them in the 'outside core hours' appointment slots if this suits the patient better. In some ways you are paying for the same thing twice but they were given funding to do it so it's going ahead!

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  • I disagree with Mike M's interpretation. It specifically says "offering a walk-in service on weekends". In other words, catering for patient deemed emergencies. The current extended hours pilot, which extends to saturday mornings, is structured as convenience appts only.

    Where are they going to get the GPs from?

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