Cambridge and Peterborough
Dr Guy Watkins, chief executive of Cambridge LMC, told Pulse: ‘Our local AT offer was I think similar to the national spec, and I believe 34 of 108 practices signed up.’
‘Other normal A&E reduction schemes (GPs in A&E etc) will operate as usual’
The local Winter Telephone Triage scheme will operate on all four days of the bank holiday weekend.
Dr Helena McKeown, vice chair of Wiltshire LMC said: ‘Our unwell patients will get a call from a local GP who is providing a call to check how they are service each day. We also have a walk-in centre in Salisbury.’
Routine out of hours is operating over the break, with a request for GPs to participate.
Dr Jane Lothian medical secretary of Northumberland LMC told Pulse: ‘We don’t have a scheme. All our practices are exhausted and need the break. [The] LMC agreed pragmatic position and practices have been asked if there are any volunteers for OOH shifts.’
Leeds LMC assistant medical secretary Dr Richard Vautrey told Pulse: ‘In Leeds we have three CCGs and they have varying schemes but essentially around 20 practices across the city (around 1/6th) will be opening at some point over the Bank Holiday period to help expand the capacity for the regular OOH service.
‘They’ll be using NHS 111 as the first point of contact. This scheme is supported by additional funding for those who have volunteered to take part and also links to the extended hours scheme that one of the CCGs has developed which new long-term funding they’ve invested in general practice.’
A mix of out of hours and routine Saturday opening.
Mike Forster, lay secretary at Gloucester LMC told Pulse: ‘In Cheltenham and Gloucester those practices which normally provide extended hours on a Saturday will be funded to do so on Easter Saturday. The hours of opening vary.’
- Cheltenham: three practices out of 17
- Gloucester: Six practices out of 18, in addition the Gloucester Health Access Centre will be open throughout the weekend 08:00 to 20:00.
Mr Forster said that elsewhere in the county care would be provided by a new out of hours provider who only took on the contract at the start of April, saying: ‘This LMC has frequently mentioned the risk that a new OOHs service introduced just before a major stressor to the system (a four-day break) may cause difficulties.’
Practices were offered a maximum payment of £350 per hour to cover staffing costs for a three hour session on the Easter Saturday, over £1,000 for one session.
Similar to Essex, but a maximum payment of £650 for a Saturday session. The area team offered ‘£150 per hour for the GP covering the three hour session and £200 per session for the remaining staff and overhead costs.’
Salford and Trafford
Dr Iain Maclean, joint chair of Salford and Trafford LMC, said: ‘Nothing in Trafford but I hear Salford might be providing money for locums on Tuesday to mop up extra workload then.’
A variety of GP practices opening and out-of-hours provision.
Devon LMC medical secretary Dr Mark Sanford-Wood told Pulse: ‘There is a mixed patchwork in Devon. The LMC has not collected figures of who will be opening and who will not.
‘The main concern locally is that the offer may actually precipitate destabilisation of OOH services. Our local OOH provider DDOC is proud that its services are largely delivered by local GP partners.’
‘Of course, if these people can earn better rates of pay for working in more protected circumstances within the structure of their own practice then they are likely to plump for that and avoid out-of-hours work over Easter which is always very difficult. Essentially, this offer could distort the priorities of a very limited workforce and generate a crisis for the out-of-hours service as the two arms are competing for the same workers. Devon LMC is not convinced that sufficient thought has been given to the potentially negative unexpected consequences of this project that seems like a “no brainer”.’
Practices were offered a LES by the area team, but actual uptake is unclear after several practices pulled out over insufficient funding or staffing difficulties.
Dr John Ashcroft, executive officer at Derby and Derbyshire LMC said: ‘The initial emails from the area team seemed to indicate a certain amount for staffing costs £200 but it turns out that they will only pay that if you are employing a nurse for the Saturday morning.’
‘A lot of practices who said they would open appear now to have pulled out of this because the money is less than expected, or they haven’t been able to find staff to cover, or doctors to cover – though both do appear linked.
‘So, many [practices are] pulling out that the area team came back this week, I believe, to confirm who was still doing them. We confirmed yesterday, and I will be doing 3 hours for my practice.’
Ten practices in Lambeth opening for at least one four-hour surgery during the Easter weekend, after the CCG offered a ‘very well paid’ LES at short notice. Other areas have additional clinic openings in additional to walk-ins and out-of-hours.
Dr Emma Rowley-Conwy, chair of SELDOC out-of-hours’ board, said: ‘We have access schemes operating in Southwark and in Lambeth (3 clinics in addition to the Walk in service which we run at weekends and BH), but not in Lewisham or Sutton.’
‘We also in Lambeth have had a last minute offer from the CCG to open to practices – very well paid – which has resulted in 10 practices offering to open for at least one 4 hour surgery over the four-day weekend. The condition was that their doctors could not cancel a duty doctor shift already booked at one of the other clinics.’
John Allingham, medical secretary of Kent LMC told Pulse: ‘All quiet in Kent. No silly open Easter Saturday LESs or pressure to sell hot cross buns. I guess we are lucky.’
What NHS England’s area teams say:
Area team told Pulse it had not sent out letters to practices by Thursday 26 March informing them about the enhanced service, and was unable to clarify if and when it did send the letters out. Despite this it estimates that 92% of patients will have access to GP services ‘on each day of the Easter weekend’, but said it would only know details about take-up for the enhanced service after the Easter weekend itself.
A spokesperson said: ‘For those areas in London where additional resources are required, we have requested that the CCGs offer the local enhanced service to their local practices. We will be able to provide the take-up figures after the Easter weekend.
‘Those opening under the local enhanced service will be open for a three-hour period. The type of service being offered will be advertised within each practice. Primary care services will also be available to patients at GP-led walk-in and health centres.’
South of England
NHS England has pleaded for GP practices to offer extra Easter opening but has not offered any extra money to do so.
A spokesperson for the south region said it also had many GPs ‘already contracted’ to open on Easter Saturday while some other practices ‘have introduced flexible working arrangements in order to provide access for their patients’.
She added: ‘There are a number of GP practices across the south region that will be open on Easter Saturday. We have been talking to those who would not normally be open on that day to see if they can offer any appointments to patients on Easter Saturday but NHS England South has not offered extra payment for this.’
North, midlands and east
The NHS England north, midlands and east regional hub said it did not hold details on take-up.
A spokesperson told Pulse that ‘most areas are able to offer access to primary care services at different points’ over the holiday, including pre-existing services at practices signed up to extended hours enhanced services