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‘Successful’ seven-day scheme could close due to lack of funds

A ‘successful’ PM’s Challenge Fund pilot may have to close because its cash-strapped CCG is unable to guarantee continued funding for extended access beyond April.  

Dr Richard Dales, who is the director of Taurus Healthcare Limited, which runs the pilot scheme in Herefordshire, said that he would like commissioners to consider reducing Sunday hours to secure enough funding for extended hours at other times.

He added that the scheme had filled just over half of appointments on Sundays. 

The comments come on the same day that Pulse reported that eight of the 18 ’Challenge Fund’ pilots – including Herefordshire – have reduced weekend services or cut the service altogether.

Dr Dales, who is also chair of Herefordshire LMC, told delegates at a Pulse Live event in Liverpool today that the scheme – which is part of the first wave of seven-day working pilots – was successful, and had reasonable uptake from patients, particularly in evenings.

He added that it had already seen its funding reduced in its second year, despite area team support.

Its future now hinges on a CCG which, like others nationally, is struggling to balance budgets and manage secondary care activity to fill the £22bn funding black hole facing the health service.

The Prime Minister’s Challenge Fund provides funding to seven-day access pilots for 12 months, after which CCGs are supposed to fund them through savings made from reduced A&E and secondary care demand. 

However, CCGs have been unwilling to make public their plans for the schemes beyond this month, stating that they are waiting on an NHS England evaluation of the pilots, which is due soon. 

But Dr Dales told delegates that future funding was uncertain.

He said: ’NHS England continue to fund it in the second year the CCG is short of cash like most of the others. They’ve got a trust in severe financial difficulties.

’The area team were very keen to support us going forward. So we’re continuing seven-day services, but it’s been adjusted so we’re doing a few less on the weekends and we’re using our Hereford hub more often.’

He added:’There is political will [but] we need to persuade our CCG colleagues who are under a lot of financial pressure to continue the service and continue funding going forward.’

‘If after April the funding goes, the service will go. We can adapt the service, but we can’t do it without the funding.’

The scheme operates from three hub practices in Hereford, Leominster and Ross-on-Wye, offering urgent and routine appointments – typically 12 minutes with the scope to increase them – and telephone triage. But it doesn’t offer home visits.

It initially ran additional hours from 6pm to 8pm on weekday evenings, and 8am to 8pm on Saturdays and Sundays, and now fills 97% of its evening and Saturday slots, and 53% of those on Sundays. 

Dr Dales added: ‘If they want to provide less money we have to reduce the services we provide. I’d like to see a bit less on the Sunday and more in the evenings, demand in the evenings is pretty high.

’Sundays we see a lot of urgent stuff. If Saturday fills up, we let it trickle over to Sunday.’