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CCGs prepare to step in to fund GP seven-day opening pilot when Government scheme ends



Exclusive CCGs are already looking at ways of continuing to support the Government’s agenda of extended access for patients when central funding runs out next year, Pulse has learned.

It comes as NHS England would not commit to funding the 20 schemes announced by prime minister David Cameron this week beyond ‘one year’. The scheme will see more than 1,000 pilot GP practices offering extended opening in evenings and at weekends, and trialling things like 24-hour telephone access, email and Skype consulations, to some 700,000 patients, with central funding supplied up until 1 April 2015.

An NHS England spokesperson told Pulse: ‘The funding is for one year for 2014/15, to help practices test new ways of delivering services and extending access and ensuring that services are sustainable beyond the first year. “The successful pilots have had to demonstrate that they have clear, credible plans for delivering benefits to patients on an ongoing basis, beyond the lifetime of the pilots. The programme will produce evidence based models of innovative practice and actionable learning about how best to implement them.’

NHS England head of primary care Dr David Geddes said: ‘I don’t think big central funding and bids is the best way always to get the best out of practices. So I think it would be useful to make sure… how we’re going to work with CCGs, CSUs and local area teams, to be able to help sponsor and support that kind of development as a provider.’

And some CCGs are already looking at ways of continuing to support the Government’s agenda when central funding dries up.

Dr Mark Grealy, a GP at Morecambe’s Coastal Medical Group who led the practice’s challenge fund bid, said NHS Lancashire North CCG has already signed up to funding the scheme in the long term if it can show it stems the ‘influx of elderly patients to A&E, especially at weekends’.

He said: ‘We want to ease the tremendous pressure on A&E and we will be measuring and evaluating the scheme over the next year, perhaps at the six and 12-month mark to see if there has been a decrease in A&E attendances and admission rates particular amongst this elderly population.’

‘The CCG is a crucial part of this and have already said that if we can demonstrate a saving of, £x – say £1m – for arguments sake, then they have committed that they will pay for that going forward if we can show these savings.’

In a grand unveiling of the pilot sites on Monday this week, the Department of Health said its one-off investment would support ‘forward-thinking services to suit busy lifestyles’. However, GPs warned that patients would become ‘disillussioned’ if these services do not continue beyond the pilot year.

Dr Ivan Benett, clinical director of Central Manchester CCG – where four localities rolled out extended access just before Christmas offering patients appointments until 8pm during the week and for six hours at weekends – warned that the pilot schemes could build up patient expectations and that if the CCG could not continue funding then the Government should.

He said: ‘I think there is a risk of disillusion by the public and profession alike. However, I’m confident that the extended hours will provide a better service and reduce urgent care activity so it will be self-funding.’

‘If not, I would sincerely hope that the Government continues to support these projects through local area team resourcing. As it is commissioning these services mainly from GP practices, I would expect this to be the funding route, rather than CCG funding which is mainly to commission secondary care services.’

Dr Richard Vautrey, GPC deputy chair said: ‘The first thing is to properly evaluate the various schemes. This must look at the impact of spreading the current service more thinly. Service expansion needs a workforce expansion to be sustainable.’

‘If the pilots are found to be beneficial but the necessary funding is not found to ensure they can continue, not just for the small number of practices involved but for all that want to provide similar services, then patients will consider this to be just a pre-election gimmick and not a serious policy to invest in general practice.’

NHS England is yet to appoint an independent evaluator of the scheme.