Exclusive GP practices in two areas of England have been hit with contractual breach notices after failing to meet the 7 November deadline for submitting their ‘e-declaration’, in a move GP leaders say demonstrate local area teams’ increasing ‘officiousness’ and willingness to issue contract breaches.
At least six practices in Essex were hit with automatic notices after failing to submit on time their annual self-declaration of their practice arrangements, such as staffing and opening hours, while at least one practice in Birmingham has been hit with a breach notice.
However, 64 practices in the south of England were given extra time to submit their e-declaration after missing the deadline, and the local area team said it will not be issuing any breach notices as a result
GP leaders criticised the variations in approaches, and said there was a move by NHS England to issue more notices.
Practices who receive two breach notices can be shut down, and this is not the first time that NHS England’s area teams have taken vastly different approaches to contractual breaches, with recent examples including last year’s Christmas closure row.
Essex LMC chair Dr Brian Balmer said his local area team said it had no choice but to automatically issue six breach notices.
He said: ‘Our area team director said that the regulations around information governance mean that “when this happens we automatically have to issue a breach”. I remember him very clearly saying it.’
Birmingham LMC executive secretary Dr Robert Morley said: ‘In Birmingham the area team advised me that they intended to issue two breach notices. With one practice the area team already knew there might be some mitigating factors, indeed the LMC was involved in providing practice support.
‘I asked the area team to reconsider the decision and don’t yet know what they are going to do. I am also questioning the legal position in respect of such breach notices as, while there is a contractual obligation under the regulations to provide information reasonably required by NHS England, this does not explicitly cover the e-declarations.’
A spokesperson from the local area team told Pulse that one practice has now submitted, but added: ‘NHS England’s guidance is that e-declaration is a requirement under the contract. Non-completion therefore may be considered a breach. The area team is reviewing the practice that is non-compliant throughout normal processes and will be taking into account any mitigating circumstances before making a final decision.’
However, the approach taken by the local area teams differs from the approach taken elsewhere.
In London alone, 45 practices failed to meet the November e-declaration deadline – representing 3.3% of practices – but despite this a spokesperson for NHS England in London said no breach notices were issued.
She said: ‘We are checking with practices on any mitigating circumstances and will consult with the LMC on any decision to issue a breach notice. No breach notices have been issued to date.’
A further 18 practices missed the deadline in Thames Valley, while one late-reporting practice was also spared from a notice in the Bristol, North Somerset, Somerset and South Gloucestershire area.
An NHS England spokesperson said: ‘The one delayed case in BNSSSG was given another week to respond. The practice met this deadline and a breach notice will not be issue.
‘In Thames Valley, although 18 practices failed to meet the deadline, this does not mean that 18 breach notices will be issued. The team are aware that some practices experienced technical problems or had extenuating circumstances. Additionally, one of the 18 practices is also due to close by the end of December.’
She added: ‘There won’t be any automatic breach notices issued in the South.’
GPC deputy chair Dr Richard Vautrey said: ‘We are aware of NHS England being more ready to issue breach notices than previously and I think this reflects their increasing remoteness from practices as their capacity is reduced. They are moving away from the more supportive and developmental role that they and many PCTs before them once had and becoming more officious in their way of operating.’
A spokesperson for NHS England in Essex said: ‘NHS England has made it very clear to contractors in Essex that the submission of an e-declaration is a contractual matter. This is the second year that practices are required to submit a declaration in this form. Last year we allowed for the fact that the requirement was new and did not breach any contract, but made it clear that if the same thing happened this year it would be treated as a contractual matter. NHS England in Essex has not yet issued any breach notices to contractors but will be issuing six notices in line with NHS England national guidance as we had given practices regular reminders regarding the deadline for the submission.’
The row over Christmas closures saw NHS England’s London area team uphold breach notices for 12 practices failing to stay open in core hours last December, despite other area teams allowing practices to close early on the same dates.