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England GP practices to open 9-5 on Saturdays under contract update

England GP practices to open 9-5 on Saturdays under contract update

GPs in England’s primary care networks (PCNs) will be required to open from 9am to 5pm on Saturdays from October under new enhanced access arrangements.

The plans were revealed today as part of the GP contract updates for 2022/23, which include changes to both the core GP Contract and the Network Contract DES.

They will require GPs to provide ‘a range of general practice services’, including ‘routine’ services ‘in line with patient preference and need’.

It remains unclear how the service will be funded.

In a letter to practices, NHS England said: ‘The new offer is based on PCNs providing bookable appointments outside core hours within the Enhanced Access period of 6.30pm-8pm weekday evenings and 9am-5pm on Saturdays, utilising the full multi-disciplinary team, and offering a range of general practice services, including “routine” services such as screening, vaccinations and health checks, in line with patient preference and need. 

‘PCNs will be able to provide a proportion of Enhanced Access outside of these hours, for example early morning or on a Sunday, where this is in line with patient need locally and it is agreed with the commissioner. ‘

The new ‘enhanced access’ arrangements aim to ‘remove variability across the country and improve patient understanding of the service’, it added.

NHS England announced in August that PCNs would deliver a ‘single, combined extended access offer’ funded through the network DES from April 2022, with further details to be published in the autumn.

It said at the time that the extended access requirements would be included within the 2022/23 DES which would be published ‘later [in the] financial year’.

However, the scheme’s launch was delayed for the second time until October 2022.

In the letter sent to practices today, NHS England confirmed that the new ‘enhanced’ access offer will bring together the current £1.44 per head Network Contract DES extended hours funding and the current £6 per head CCG-commissioned extended access services – into the PCN DES.

Delivery will start from October 2022, with ‘preparatory work from next month, it said.

PCNs will need to provide a ‘minimum of 60 minutes of appointments per 1,000 PCN adjusted patients per week’, with bookable appointments for ‘any general practice services’, it added.

However, it remains unclear how much they will be funded for the service.

The appointments – which must be bookable in advance or on the same day – must be a ‘mixture of in-person face-to-face and remote’ , with a ‘reasonable number’ of face-to-face consultations available.

And PCNs must ‘make available to NHS 111 any unused on the day slots’ that fall within the hours of the service, unless they have agreed with the commissioner that ‘the timing for when these unused slots are made available is outside of these hours’.

NHS England said PCNs must ‘work with their commissioner to produce and agree an Enhanced Access Plan‘ to ‘prepare for delivery’ of the service from 1 October 2022.

Plans must be submitted by 31 July with a ‘final iteration’ agreed by 31 August.

It comes as a BMA GP Committee negotiator has suggested that the 2022/23 changes to the GP contract are imposed.

And last week, a study found that the Government’s flagship CCG-commissioned GP extended access scheme, which costs an estimated £250m a year, had ‘no measurable impact’ on patient access to appointments.

What are the current GP access requirements?

Network Contract DES extended hours:

  • Appointments to be held outside of ‘core’ hours, which are 8am to 6.30pm for GMS practices
  • Minimum of 30 minutes per 1,000 registered patients per week
  • £1.44 per head

CCG-commissioned extended access services:

  • Weekday pre-bookable and same-day appointments in evenings (after 6:30pm) to provide an additional 1.5 hours a day
  • Weekend pre-bookable and same-day appointments on both Saturdays and Sundays to ‘meet local population needs’
  • Minimum 30 minutes per 1,000 population, rising to 45 minutes per 1,000 population
  • £6 per head 

Source: PCN DES and NHS England guidance



Please note, only GPs are permitted to add comments to articles

Patrufini Duffy 1 March, 2022 4:06 pm

They’re coming for you. Big time.

Kevin Booth 1 March, 2022 4:12 pm

Dear pulse
It is 1st March not April

Michael Mullineux 1 March, 2022 4:19 pm

The inevitable mission creep we warned our colleagues about before they signed up to the PCN project.

Robert James Andrew Mackenzie Koefman 1 March, 2022 4:24 pm

Have they gone insane will never be worth the money offered. Thanks goodness we never signed up to the PCN from the start. The only way to make it work would be to have less people working on the other days no sense at all.

Andrew Moltuv 1 March, 2022 4:54 pm

Confirmation of why I am retired in September

Patrufini Duffy 1 March, 2022 5:37 pm

PCNs will need to provide a ‘minimum of 60 minutes of appointments per 1,000 PCN adjusted patients per week’, with bookable appointments for ‘any general practice services’.

So a 50,000 list PCN needs a minimum of *200 slots per week (if each were 15 minutes).
For ANY GP service.

There are gonna be some GP Partners (not their locums or salarieds) sitting in clinics on a mind numbing rota seeing other practices’ patients thinking “what on earth am I doing here? Hung and quartered. To those PCNs that are just a group of your own multiple sites, you’ll be salivating – but thats where this model breaks down. Those PCNs who are just conglomerates (with no working together whatsoever, just their own branches) are just laughing at more dollar, less in hours work, more diverted work. You do realise that NHSE or just choose to ignore the superpractice PCN?

Reply moderated
Keith M Laycock 1 March, 2022 5:38 pm

I left the NHS Jewel in the Crown in 1975 for pastures greener – alas, no longer greener, more frizzled and brownish – however, even in 1975 our 3 GP practice ran a Saturday morning surgery with 1 GP on rotation.

This is just an observation and is not to suggest support for this latest NHS England’s edict. They do seem determined to eradicate or enslave GP practice.

A current report in The Medical Post, Canada, gives the GP-to-Patient ratio as 1.3: 1000 population: – 770 pts per GP with the average weekly pt’s seen given as, at the highest provincial number, 125. The docs are, apparently, ‘overwhelmed’ and ‘burned out’.

The previous 3 GP NHS practice above had 7,500 patients rostered. Wonder what it is now?

As per Spike Milligan’s epitaph, the NHS gravestone may read : – ‘I told you I was ill’

Nigel Rowell 1 March, 2022 5:43 pm

Jam being spread thinner, and thinner…
I used to do Saturdays for 16,000 patients.
I was often overwhelmed and the service abused.
And those were the Good Old Days.

David Jenner 1 March, 2022 6:37 pm

Just all resign the PCN DES before 31/03/2022!
BMA seen unable to organise industrial action themselves but individual practices can just resign .
Likely only thing that will bring them back to the table .
You Might lose some cash but you lose a shed load of work and hassle and ICS have to find someone else to do the Saturdays .
Likely you could earn the money back doing the odd session but without the commitment to provide it!
After all there are not many GPs to do the work !

Slobber Dog 1 March, 2022 8:33 pm

Here we go again,

Dr N 1 March, 2022 10:52 pm

Do they actually understand what, ‘ recruitment crisis’ means?

David Church 1 March, 2022 11:21 pm

That’s £55 per hour.
Cost of 2 Receptionists (can’t work alone) – £30 (antisocial supplement to minimum wage)
Cost of Nurse £ 25
Leaves income for doctor of 38.5 pence per hour.
If you want to take ONE whole week off, and need a locum, it will cost you about £ 120 per hour (all inclusive), but you are unlikely to get one to do a half-hour surgery below £ 200 including travel costs, etc, because it is a waste of a whole session to the locum. So it will cost you to provide the service for 2,000 patients, and more for 5,000 patients.
Unless you use the time to do HGV medicals?

Reply moderated
David Church 1 March, 2022 11:24 pm

Assuming that Pulse do not have a faulty camera, I would say this is an attempt by NHSE to prove a point – just how far can you go before the GPs actually become militant and say something extreme, like, er ‘no’.

David Church 1 March, 2022 11:24 pm

Calendar, not Camera, sorry !!

David jenkins 2 March, 2022 2:06 am

David Church

well said !

aren’t we lucky that in wales we have different, and slightly more sensible, idiots running the show ?

Turn out The Lights 2 March, 2022 9:29 am

In or out of a PCn will not be doing NO ,NO,NO.They dont get it difficult to impose,when folks are that burnt out.Spread the jam thinner.The BMA dont represent me.Try to impose they can have the contract back.

Long Gone 2 March, 2022 10:28 am

This is the sort of edict that used to drive me crazy with indignation. They have long had the measure of us – that we’re too entrenched in our chosen profession to leave without a lot of planning and preparation (it took me 10 years to dig that tunnel) so they can largely do what they want with us.
I thank myself on a daily basis for getting out. Like a millstone being removed from around my neck. I am so sorry for those still stuck in there, trying to do the good work.

MULAYIL KRISHNAN Gopinath 2 March, 2022 10:50 am

Time to become salaried. Let NHS England have all the headaches.

ANTHONY Roberts 2 March, 2022 12:45 pm

There are no more GP ‘s .
If people work an evening they will probably go in later the next day.
If they do a Saturday they will probably take Monday off in lieu.
It will not produce any more appointments each week.
It will also hurry up people leaving the profession.
NHSE mess things up again.

Coastal GP 2 March, 2022 1:06 pm

I have 8 more sessions as a partner and at the age of 58 I am leaving General Practice on March 31st.
I was hoping to work as a partner for many more years but last October I took a week off for the first time since the beginning of covid and realised that if I wanted to maintain any semblance of mental health I had to get out.
In the last 6 months I have seen NHSE set out to destroy everything I worked for in the last 40 years.
I am off !! anyone joining me ?

Chris GP 2 March, 2022 1:15 pm

Just as soon as I can Coastal! aiming to go in a few years – mid 50’s. Like you – when i started all this I wanted to work until I dropped. Truth is – right now I would go tomorrow if I could. NHSE asks for 60 extra minutes per 1000 patients per week. I might ask for every MP to give every constituent a guaranteed hour of their time every month. They would both be arbitrary and stupid impractical requests for exactly the same reason.

Dr N 2 March, 2022 3:59 pm

Dear GPs in your late 50s – On 1st April your pension, like it not, will move to the 2015 scheme and any protection you had for annual allowance will be lost over night. And now they expect you to work Saturdays for pence.

Stop paying into your pension now and retire.

Dave Haddock 2 March, 2022 5:47 pm

Dr Jenner, above, suggests simply resign from PCN.
This is the obvious response is it not?

Nav Ijaz 2 March, 2022 8:19 pm

This will be the final deciding factor for me to resign and leave the uk. They can F right off

Mike Pearce 2 March, 2022 9:55 pm

Dave Haddock.. YES!

PAUL BALLINGER 2 March, 2022 10:58 pm

Actually I welcome this move.. Its great for patients and who minds working Saturdays if you get an extra day off in the week.Why all the negativity ??

Coastal GP 3 March, 2022 10:31 am

Paul.. work Saturday and take a day off during the week.

We will need to provide around 15% additional clinical care with a clinical workforce that is withering on the vine. Even if we utilise the pharmacists, paramedics and nurses to bolster these services i doubt you will be taking an extra day off during the week.

David Jarvis 3 March, 2022 12:22 pm

They are offering some money to provide a Saturday service. It is quite clearly an insultingly small amount of money so they can shove their money. Carry on as we are and what will they do? Close us down or sack us?
How many GP’s realistically are chasing extra income. We only get a fixed amount of life and they are only able to afford a certain amount of that precious time. The pension and tax cliff produces a very clear cut off beyond which most of us will do something less boring instead. I am not convinced the govt position is that strong if we say no do our worst. We aren’t opening Saturdays for any amount of money.

J B 3 March, 2022 2:22 pm

I am nearly 2 years out of training , having trained in another speciality I completed GP training and came out during the pandemic . Ive been asked to be partner due to our partners are breaking point . Im saying yes to help out .

Can someone just tell what the hell is going on ? Is the imposed contract legal and can they do this ? Or is this something agreed to in the past. If so then we have to accept it.

Otherwise if this is not legal or wrong then dont we have the right to challenge this as a profession ? If not now – then when ? Until it is destroyed and privatised or we all give up ? Even 2 years on my cohort are burnt out .

Im really not interested in apologetic letters from the BMA apparently blindsided, or our reps on twitter saying how demoralizing it is . Im interested in moving forward or action from our reps . Talk is cheap and apologies and words will not get us out .

J B 3 March, 2022 4:16 pm

Also If we are all just burning out , and accepting these impositions, and taking the wrap for all the system failures – isn’t it just better for all of us to recognise the governments plan of privatisation and just say ” enough is enough we give up!!! , please privatise already ”

And full on support privatisation shed light on this plan – openly rather than slowly burnt out, into a shells , suffer ill health physical and mental or be brought infront of the GMC or complaints procedures due to the errors made as a result of time pressures and understaffing and underfunding and workload.

We need to look after ourselves better, as clearly we have no union or no voice that is heard or impactful . But if we all say privatise people will listen .

David Banner 3 March, 2022 4:57 pm

The vaccine refuseniks were threatened with the sack, but held their nerve, and in the end there were too many of them to fire, so the government blinked first and suffered a humiliating climb down.

We must learn from this. If enough of us say NO to this outrageous imposition, what are they going to do? Sack us all?? Just ignore it and carry on, take whatever punishment beating they choose to hand out, but stand tall.

I implore every GP to urgently inform their PCN that they will not be complying with this dastardly diktat . Resign from the PCN if the rest of them are too lily livered to resist.

If you tolerate this, then your children will be next.

Michael Mullineux 3 March, 2022 5:34 pm

Great Manics quote DB
It is absolutely brilliant not to be part of the PCN project for this and many reasons detailed exhaustively previously – just do the sums, and then leave.

Hot Felon 3 March, 2022 5:55 pm

Don’t make me laugh, Saturdays are back!
Finish in 35 days.
No Saturdays for me, Saturdays are ONLY for Gillette soccer Saturday with Jeff Stelling, NOT another 4 hours of fibromyalgia, tingling, dizziness and Language line for illegal Bulgarians.
More sticks to beat Yes Men who supine themselves to every whim.
Good luck with that dudes.
1995 pension, came out of it age 50, protected 1.25 lifetime allowance with not a single penny of tax charges.
Jealous? You should be!

Finola ONeill 3 March, 2022 6:03 pm

Seems totally obvious to withdraw from PC DES. It is a variation of contract clause with open terms. No business on earth would ever sign up to that. The extra roles are just doing stuff dumped form hospital. Our physios do the hospital physio stuff, one was the hospital ortho interface before, because the wait is so long for OP ortho or physio. The PCN pharmacist changes a couple of meds and then tasks me anyway. Our own pharmacist employed by the surgery actually sorts the patients. The visiting paramedic is useful. The social prescriber and wellbeing person, from private company thrive tribe, have all empty appts. Most patients have 5 things need sorting. outsourcing one to an additional role does nothing for me. Ditch the DES. reuse any variations in original CCG contract, work to rule.
Salaried under NHSE is what they want. then we really are their bitches and they can be even more awful.
Ditch the DES. individual practices can do that so doesn’t even rely on the BMA getting their sit together.
Even if only a significant number do it it is enough.

J B 3 March, 2022 6:14 pm

Well congratulations and you deserve your pension , you have worked hard and deserve soccer Saturday .

But im in it for another 15 years so we either stop moaning and be productive and find a solution whether its ALL saying NO or agree to move to privatise the whole system

Paul Charlson 7 March, 2022 1:17 pm

I do not do much GP work since 2009. Frankly there are better ways of earning a crust. Either people need to get creative with the way they work so that the sums add up or just refuse to take on extra work. It is a matter of what is financially viable and how many hours you want to work.
A GP should be able to find a way of working a reasonable number of hours and earn a decent income. Working as a locum 40 hours a week for 46 weeks a year =220K
Even with sickness insurance , pensions and the like that has to be worth about 140k
£75 an hour after expenses- what is this DES paying

Doing this DES is ridiculous it does not add up!

Sangeeta R 3 November, 2022 10:13 am

I also resigned in July this year after being a GP for 24 years at the age of 58. We were already doing late evening surgeries to 7.30pm and now my colleagues are also doing Saturday surgeries 14,000 patients 2 1/2 partners and two part-time salaries. We haven’t been able to recruit a new GP in London for over three years. I’m sad to go but I’m tired of being tired.