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No new funding for GPs to take back out-of-hours responsibility

By Ian Quinn

Exclusive: GPs will receive no extra funding for taking on responsibility for commissioning out-of-hours services, the Government has revealed.

Primary care tsar Dr David Colin-Thome told Pulse that because GPs are not going to be forced to take on provision on out-of-hours - and will instead be able to commission cover from other providers if they wish - there will be no incentives or funding provided.

However, he revealed GPs will be forced to take on massive new contractual challenges, involving seeking to re-negotiate or terminate existing deals with a raft of NHS providers, including out-of-hours companies.

Full responsibility for commissioning out-of-hours services in England will transfer from PCTs to GP consortia in April 2013 but Dr Colin-Thome said existing practice-based commissioning groups are expected to take a much bigger role immediately.

‘Individual GPs and practices won't be asked to take back responsibility for providing out-of-hours services,' he said. ‘It will remain the responsibility of the commissioner.'

‘You [GPs] will be responsible for commissioning out-of-hours services, not for providing the services themselves. As such, the sum given up in return for the opting out of out-of-hours provision under the 2004 GMS contract will not be reimbursed, but will remain part of the overall funds available to support commissioning of out-of-hours services.'

However, the primary care tsar said the onus will fall squarely on GP consortiums to take on management of contracts, as power shifts from the soon-to-be-scuttled PCT network in England, plunging GPs into a potential legal minefield of NHS contract renegotiations.

Dr Colin-Thome, who today answers questions from Pulse's readers on key elements of the coalition Government's health White Paper, was asked by Dr David Connolly, a GP in Salisbury, what would happen to external contracts, such as a five-year deal signed by his PCT recently.

The primary care tsar replied: ‘GP consortia will have to look at these contracts carefully and renegotiate, terminate or vary them as they see fit.'

‘Contracts should contain clauses governing a change of commissioning organisation. These should be taken into account when GP consortia take the contracts on.'

As well as making the decisions over out-of-hours providers, it means GP consortiums will make decisions over the future of many services which have often been brought in with great opposition from practices, including the use of management consultants and private firms running services in the community.

Out-of-hours: new reponsibility but no extra money for GPs Out-of-hours: new responsibility but no extra money for GPs The White Paper explained

To read the full response to GPs' questions from primary care tsar Dr David Colin-Thome, please click here.