GP practices may have to open normal hours throughout the Christmas holidays if commissioners decide out-of-hours services are unable to cope with the extra demand, NHS England has said.
As the holiday period is approaching, NHS England’s official guidance says GP practices can close early on non-Bank Holidays only if they have ‘prior written agreement with both the provider and the CCG commissioner of that service’.
But NHS England added that early closing ‘may not be a reasonable or sustainable option’ if commissioners feel out-of-hours services are under too much pressure.
This is the latest in the annual row over Christmas and New Year opening, which has seen some practices clapped with breach notices for closing early.
Christmas Eve and New Year’s Eve this year fall on a Saturday, but traditionally practices have often closed early on the last working day before Christmas and New Year due to slower demand.
The current guidance released by NHS England said: ‘GP out-of-hours providers have previously expressed concern about early closing of general practices at Christmas and New Year and the potential impact on them.
‘Given the pressures that out-of-hours providers already face during this period, this may not be a reasonable or sustainable service option.’
It said it will be up to NHS England regional teams or CCGs commissioning general practice to decide whether practices can close early or have to remain open on these days.
The guidance said: ‘The contract regulations require a practice to notify their commissioner of their proposal to sub-contract.
‘Where this is the case the commissioner will need to be assured that such an arrangement will deliver essential medical services during core hours otherwise the commissioner will be unable to accept the proposal.’
NHS England warned that if practices fail to follow these steps, they are at risk of being slapped with a breach of contract notice.
The guidance said: ‘In summary practices are expected to be open from 08:00 to 18:30, Monday to Friday excluding bank holidays, unless alternative arrangements are agreed in advance.
‘If these arrangements are not in place, or if tested they fail, this may amount to a breach of your contract.’
GPC contracts and regulations lead Dr Robert Morley said that if practices wished to close early over the holidays, this ‘would be perfectly legitimate under the regulations if it is going to be clear that demand for appointments will be low and practices are still meeting the reasonable needs of their patients’.
He said: ‘It is highly unlikely that such early closing will then lead to any increase demand during the out-of-hours periods. Practices might choose to deal with this by having a practice duty doctor on call or reciprocal arrangements with another named GP.’
He added that although subcontracting to an out-of-hours provider ‘would require the commissioner’s consent’ this ‘must not be unreasonably withheld’.
The letter comes as last year GPs and staff were allowed to leave early on Christmas Eve and New Year’s Eve, after NHS England revised its guidance on the long-running saga which saw practices handed breach notices for closing early and reverting to out-of-hours services.
The GPC’s official advice is for practices to ensure that:
- patients are aware of any closures in advance by using surgery notices, and including messages on repeat prescriptions;
- arrangements are in place to ensure that repeat prescriptions are ordered and collected in a timely matter to avoid requests over the period of practice closure;
- answer phone messages should be changed at 18:30 on the afternoons of early closure – in particular – for opted out practices where there is a change from the sub-contracted provider to NHS 111.