The health secretary has given his backing for GPs in Hackney to regain responsibility for out-of-hours care following a controversial decision by the previous PCT to prevent them from doing so.
At the NHS Clinical Commissioners conference today, Jeremy Hunt told the chair of Hackney CCG, Dr Clare Highton, that the group should ‘be brave’ and call on NHS England to overturn the PCT’s decision in January and do what they believe is best for patient care.
However, Dr Highton told Pulse that despite the apparent backing of Mr Hunt, the CCG was still concerned that its preferred option of GPs taking back out-of-hours provision could be blocked under competition rules.
Dr Highton said that the CCG was concerned about local out-of-hours provision and supported action by local GPs to take back responsibility.
She told Mr Hunt: ‘We would really like your help and advice on whether we should be brave and ask NHS England again if our GPs can opt back in because as a CCG, that would be absolutely crucial to help us contain demand.’
The health secretary replied: ‘Be brave. That is a perfect example of local clinical leadership, of people locally understanding what it takes to provide an out-of-hours service.
‘It is a major area for concern throughout the country, the provision of out-of-hours care and we have to address that.
‘Sometimes our hands are tied with the processes you have to go through. But you know that if what you are doing is in the interests of patients, you will get there and I would encourage you to do those things to make those important changes.’
Speaking to Pulse afterwards, Dr Highton said it would be ‘hard to say’ how valuable Mr Hunt’s backing would be because of the section 75 regulations, which state that services must be put out to tender unless it can be proved that only one provider can deliver them.
She said: ‘A lot of CCGs are interested in the idea of GPs opting back in to out-of-hours,’ Dr Highton told Pulse. ‘It is a different level of taking responsibility than everyone competing for an OOH contract.
‘His answers on Section 75 suggest we do have the freedom but most CCGs are very anxious about ending up in court, as were PCTs. It is still a very live issue. As CCGs, we can say we would back our practices if they requested it but it is NHS England and/or the secretary of state’s decision as to whether to let GPs opt back in.’
She added that she was worried that there would be problems in court if they took the decision to put out-of-hours care back in the hands of local GPs.
‘We’ve had detailed legal opinions and they said it is anyone’s guess how it would go in a court of law.’
Dr Deborah Colvin, a GP in Hackney who has led the campaign to take back responsibility for out of hours care, said: ‘I find it quite interesting given that I wrote to Jeremy Hunt asking for his help after the PCT made its decision and he wasn’t interested.
‘It blows my mind really…. I think it is just him soundbiting. I have seen no evidence that anyone in the Department of Health gives a damn about local people getting what they need.’