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GPs plan to defy NHS England over Christmas early closure

Exclusive Practices are planning to defy the threat of a breach of contract notice from NHS England and close early on Christmas and New Year’s Eve, Pulse has learnt.

Londonwide LMCs confirmed at least two practices in London have said they will ‘definitely’ hand over to their out-of-hours service earlier than usual on these days, while Essex and Sefton LMCs said they believe ‘many’ practices will only be providing reduced services.

One LMC leader in Manchester has even claimed that practices there have been granted the option to close early by the local area team.

Pulse revealed earlier this month that head of primary care at NHS England Dr David Geddes had written to all area teams to insist that it was ‘non-negotiable’ that GP practices open for their full core hours on Christmas Eve and New Year’s Eve warning that practices which decided to close within core hours could be in breach of contract.

But LMCs have been writing to area teams challenging the latest NHS England directive stating practices must provide all usual routine and urgent care in core hours, after the GPC advised practices that they are legally entitled to close early.

Dr Tony Grewal, medical director at Londonwide LMCs, told Pulse he knew of two practices that would be closing early. Dr Grewal said: ‘I’m aware for definite of two practices. They are going to completely close their doors and switch over to an out-of-hours provider.’

He added: ‘If practices are going to close early I’d like them to just do it, and with luck NHS England will never find out about it. It’s such a waste of everybody’s time this ridiculous business.’

Dr Brian Balmer, Essex LMC medical secretary said he believed many practices would be operating with a scaled-back service – and that the LMC would be backing them to do so.

He said: ‘We’ve sent the [area team] a very strong email in support of practices, with GPC advice we believe to be legally correct. The area teams are being pushed by Leeds [national NHS England office] to do this. We will defend practices who fulfil their contracts properly.’

But he warned the area team could monitor which practices have flouted the national directive. Dr Balmer said: ‘I’m sure there will be some sneak phoning around practices on Christmas Eve.’

Similarly, Dr Andrew Mimnagh from Sefton LMC said many practices there were likely to ignore NHS England’s directive.

Dr Mimnagh said: ‘The issue is NHS England appears to be exceeding its remit by specifying to practices what “adequate” medical care for GMS is. All practices by their contractual definition will be fully providing services, but I would hazard a guess eight out of 10 GMS practices may not be servicing it in the specified manner of NHS England. And I understand the GPC has grown a set and indicated it will support any practice fulfilling its contract with whom NHS England takes umbrage.’

Dr John Hughes, honorary secretary at Manchester LMC, said practices had agreed with their local area team to close at 4pm on Christmas Eve and New Year’s Eve, before NHS England ruled out early closing –  and that the LMC did not expect this agreement to change.

Dr Hughes said: ‘It was a compromise agreement which most practices seemed happy with. As far as we have gathered from our area team, their view is they have made a satisfactory agreement with practices, that there hasn’t been any evidence in Greater Manchester of major demand over that time of day.’

A spokesperson for NHS England in Greater Manchester said: ‘GP practices shall retain clinical responsibility for the provision of patient care during contracted hours, and continue to offer access to routine and urgent care. In some situations practices may engage call-handling deputising arrangements for telephone calls.’