Exclusive Practices across the country have been threatened with breach of contract notices if they fail to open from 8am to 6.30pm on Christmas Eve and New Year’s Eve, Pulse can reveal.
NHS England has told local area teams that Christmas Eve and New Year’s Eve must be treated just like any other day, leading to some local area teams sending letters to GPs warning that any attempts by practices to outsource work to out-of-hours providers will result in breach of contract notices.
The warning comes despite LMCs seeking legal advice and insisting that early closing is permitted by GP contract regulations.
An email obtained by Pulse from Amanda Alamanos, primary care lead for Shropshire and Staffordshire local area team, warns that practices must not sub-contract services.
It says: ‘The area team stance is that practices should remain open their normal opening hours on Christmas and New Year’s Eve and does not agree to any practice subcontracting their responsibilities to another provider.’
‘In line with that, and as conveyed to LMCs, if practices do not open their normal opening hours on these days it will be considered a breach of contract and the relevant notice will be issued against the practice.’
Similar letters have been sent out by local area teams in Birmingham and London.
A spokesperson for NHS England said: ‘NHS England recognises the need for patients to access high-quality primary care services in a timely way.’
‘In support of this, and to ensure a more consistent approach to opening hours, primary care services are required to meet their contractual obligations. This includes opening normal hours on Christmas Eve and New Year’s Eve, which are working days.’
However, GP leaders argued that demand from patients is traditionally less on those two days, and insisted the contract does not necessitate practices remaining open throughout core hours.
Dr Robert Morley, chair of the GPC contracts and regulation subcommittee and executive secretary of Birmingham LMC, said the issue was being discussed at a GPC level.
He said: ‘For [local area teams] to refuse to subcontract, they have to give a valid reason. That would have to be on the basis of practices not meeting the reasonable needs of their patients. There is no way the area team could evidence that on traditionally quiet afternoons when a service provided by a good out-of-hours provider will be perfectly safe and adequate.’
Dr Tony Grewal, medical director of Londonwide LMCs, said: ‘As long as practices ensure that they have contracted with an out-of-hours or some other service so they have a fall back, there is no reason why they should not give due notice to the contracting authority and close early.’
‘We have taken that to BMA lawyers and they agree with our understanding,’ he added. ‘We have contacted all our practices to let them know this is the case and we will support practices to the very limit, even taking it to the first-tier tribunal of the Family Health Services Appeal Unit if any practices are issued with breach notices or worse.’
Dr Grewal added that working full hours on these days was a ‘waste of everyone’s time’. He said: ‘We have all done those shifts where for some reason or another we couldn’t use out-of-hours providers in hours and some poor so-and-so sits there in the waiting room reading 20-year-old copies of Woman’s Own and absolutely nothing happens. No-one comes, no-one rings, it is absolutely dead.’