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Drum up seven-day demand to keep pilot funding, GPs told

Exclusive Practices piloting seven-day working have been set targets to ensure at least 60% of their appointments are used, and those falling short are being asked to submit plans on how they will boost demand.

GPs in Greater Peterborough, one of the second wave of areas to pilot weekend and evening opening through the GP Access Fund, were told the target was set to ‘evidence appropriate use of funds to NHS England’.

The target was introduced in a subcontract by The Greater Peterborough Network Ltd (GPN), a GP provider company set up to deliver the GP Access Scheme across 29 practices in the region.

Practices falling below target have now been sent letters advising that they should ‘review your current activity, and implement improvement measures with immediate effect’, or risk losing the funds.

The letter, from GPN executive board director Dr Sanath Yogasundram and GP access project manager Rob Henchy, said: ‘In accordance with the Year 2 GP Access Fund subcontract, we require practices to achieve a minimum of 60% utilisation of appointment slots offered.

‘The reason for this is that we need to demonstrate we are responding to patient need and maximising value for money, and also provide sufficient evidence of appropriate utilisation of funds to NHSE.’

It then directs practices to ‘review your current activity, and implement improvement measures with immediate effect’, adding: ‘Please can you consider how to increase utilisation and reply to this letter with how you will do this… If you would like support to do this we would be happy to do this with you.’

But a local GP, who wished to remain anonymous, told Pulse: ‘I’m extremely concerned about the new minimum 60% stipulation… There is little legitimate demand for these services and that is why there is an attempt to artificially demonstrate the opposite.

‘It is illogical to cover the lesser demand but payment for this is higher than normal daytime services. Practices just cannot realistically refuse.’

GPC deputy chair Dr Richard Vautrey said that the GP federation’s strategy was ‘putting the cart before the horse’.

He told Pulse: ‘Just trying to fill appointments just because they’re there seems non-sensical and begs the question if it is the most important place to invest resource.

‘Setting targets like this can lead to unintentional consequences.’

Pulse made several requests for comment from Greater Peterborough Network Ltd, but received no response. Meanwhile, NHS England declined to comment on a ‘local contractual issue’.

NHS Shared Planning Guidance 2017/19 says GP Access Fund sites should ‘ensure 100% coverage of extended access’, but it does not specify a target for uptake of these slots.

The news comes after No 10 briefed national media last weekend saying GP practices will have to demonstrate a lack of demand from patients or open seven days.

Greater Peterborough was awarded £2.6m through the GP Access Fund – then known as the Prime Minister’s Challenge Fund – in April 2015, to trial extended hours and new technology to boost access.

Where’s the demand for seven-day access?

The first line of the 2015 Conservative Manifesto pledges to ‘provide seven-day a week access to your GP’ and Pulse analysis has shown the Government will plough £1.5bn into delivering this by 2021.

However even this may not be enough. In the announcement last Autumn that an extra £6 per patient would be invested to roll out extended GP access, the pledge to open on Sundays was notably absent, with the stipulation instead to satisfy local demand.

This came as NHS England’s final evaluation of the wave one pilots of the GP Access Fund showed it had had ‘no demonstrable impact’ on A&E admissions or out-of-hours GP services.

GP leaders went into the New Year rebutting Theresa May’s assertion’s that general practice wasn’t providing the access patieints want, warning that with current resources the seven-day ideology could undermine core service.