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Out-of-hours GP services ‘to provide bookable appointments’

GP seven-day targets can be fulfilled by existing out-of-hours services providing bookable non-urgent appointments, NHS England’s commissioning lead has said.

Speaking this morning to the House of Commons Public Accounts Committee (PAC), national director for commissioning development Rosamond Roughton said that this could be a method for CCGs in rural areas, where unlike in cities there is not sufficient demand for 8-8, seven-day routine appointments.

Her comments come as an NHS England and NHS Improvement letter sent to CCGs this morning said they will have to ‘roll out evening and weekend GP appointments, to 50% of the public by March 2018 and 100% by March 2019’.

Pushed by MPs on the PAC, Ms Roughton admitted that there was a risk that the policy would mean a duplication of already existing out-of-hours services.

But she said: ‘I think this is definitely a risk… and that’s one of the main reasons why we are devolving the money to local commissioners to draw up plans.

‘Because they understand what is the range of services that this extended access needs to be connected with. It is also why we have set up some of the flexibilities that are there, because I think what we found from some of the pilot schemes is that in parts of the country with quite disperse population – so if you take the kind of East Riding of Yorkshire – it would not be cost-effective to be having the same concentration of extended access hubs as you might have in the middle of London.

‘You might be better off using the GP out-of-hours service that is already there to be providing bookable appointments on top of their urgent care services.’

She said NHS England is scrutinising CCG plans to check they are not dupilicating and paying twice for the same services.

As previously reported, CCGs will be given £6 per head of population to achieve the target from 2019, but speaking to the PAC this morning NHS England chief executive Simon Stevens said ‘the in-year cost is going to be closer to £3-4 a head’.

The Department of Health has mandated NHS England to ensure that 100% of patients have access to weekend and evening routine GP appointments by 2020 – on the back of the Conservative Party’s 2015 election manifesto.

Speaking at the same PAC meeting, DH permanent secretary Chris Wormald was asked why the seven-day routine appointment agenda was being pushed.

He said: ‘The first thing to say, is we are of course implementing a manifesto commitment here.’