This site is intended for health professionals only

Why is NHS England cracking down on in-hours closing?

What is NHS England doing about in-hours closing?

NHS England is working on setting out a national policy for what level of access is expected from practices within core contracted hours.

Why is it doing this?

Improving access to general practice is one of the main political objectives of the Government, because it believes this will reduce untenable pressures on expensive urgent care services.

What does the GP contract say about in-hours closing?

As it stands, practices holding GMS contracts can close in core hours as long as they have measures in place that meet the reasonable needs of patients. For practices on PMS contracts it would depend on the agreed terms of specific contract.

What issues has there been with this?

Before Christmas, NHS England wrote to GPs to say that they would not be allowed to close early over Christmas but must remain open during core working hours. However GP leaders argued that this reading of the contract was wrong and practices had a right to close early and divert to out-of-hours cover organisations.

While most practices around the country either adhered to the rules, or came to a local agreement with the area team, some practices defied the letter and closed early anyway.

This became a problem when the London area team put staff to call round all of the capital’s GP practices to see if they remained open, and subsequently issued breach notices to those that were not.

What is this new policy likely to say?

It is likely to say GPs should not completely close in hours because it is reasonable to expect patients should be able to access routine care in core hours as well booking appointments and ordering repeat prescriptions.

Does that mean GP practices will no longer be able to close for an afternoon to do training?

Maybe not, if you have a collaboration with a neighbouring GP practice which has access to the practice’s appointment system and patient records or your patients are satisfied with their level of access.

What will determine whether a practice can close in hours or not?

NHS England has said it will advice area teams to base decisions on responses to the Patient Survey, so if a practice is rated poorly on access it may have to review in-hours closing.

What is the GPC’s input in all of this?

The GPC met with NHS England in February to discuss the Christmas closing row. After the meeting, the GPC said it was reassured that NHS managers were ‘committed’ to allow GPs to continue to close in core hours. It has since emerged that the GPC agreed to NHS England plans to set out a national policy for in-hours closing so that area teams can take a ‘consistent’ approach.