Extended hours set to disappear as PCTs review funding

By Gareth Iacobucci

Almost two-thirds of GPs offering extended hours will stop next year if PCTs remove funding, with over half of trusts considering withdrawing local funding in light of the Government's scrapping of national access targets, Pulse can reveal.

Health secretary Andrew Lansley recently announced his intention to abolish the national target for 50% of practices in each PCT to provide extended hours as part of his bonfire of NHS targets.

And a Pulse survey of 350 GPs currently providing extended opening, only one in seven said they would definitely continue to work early morning, evening and weekend shifts if funding was withdrawn - with the remainder undecided.

Freedom of Information responses from 107 PCTs shows that over half of trusts are reviewing their use of extended hours LES's for next year, with many likely to scrap funding if the national DES is removed following the abolition of the target.

Only a quarter of the 98 trusts currently offering extended hours said they would definitely offer the service next year, with the majority set to re-examine their service and one in five yet to decide whether to review arrangements.

These included NHS Hounslow, which said: ‘in light of the White Paper [the] Enhanced Services budget is likely to be reviewed with PBC Consortia', and NHS Cambridgeshire, which said it would ‘review according to changing national priorities'.

A Department of Health spokesperson told Pulse there had been no decision on the future of the national funding for extended hours, but said ‘discussions would be on-going with the GPC' over a possible discontinuation of the DES.

Of GPs responding to Pulse's survey who currently provide extended hours, 60% said they would stop providing the service if funding is withdrawn, while just 13% said they would continue, and 27% said they did not know.

Dr Alan Keith, a GP in Rotherham, which is reviewing all its enhanced services in 2010/2011, including extended hours, said his practice would stop offering shifts outside normal opening hours if funding was withdrawn.

He said: ‘It has not been a runaway success, and has been a bit of a damp squib. The biggest problem we have had is lots of DNAs. In some places it might be working, but here, it was all a bit pointless, and tackling a need that wasn't there.'

Dr Michael Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon, said GPs should be wary of giving up extended hours if it went against their patients' wishes, regardless of how it's funded.

He said: ‘In an ideal world, each practice should be talking to its patients, rather than to Government targets.

‘Clearly, patient experience will enter the payment structure in one way or another even if not through the extra extended hours DES.'

He added it may also see some practices losing patients to practices that do offer the service, particularly when practice boundaries are abolished.

‘Practices that have wider opening hours are going to more competitive than the ones that don't. So I suppose it's a caution to those that are thinking of going back to what they had before.'

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Plan to continue – 13%
Plan to stop – 60%
Don't know – 27%

Source: Pulse survey of 350 GPs currently providing extended hours

Reviewing LES for next year - 57%
Not reviewing LES – 25%
Undecided – 18%

Source: Pulse survey of 98 PCTs currently offering extended hours