Exclusive Local plans to manage winter demand are requesting GP practices provide extended hours to reduce the pressure on A&E departments – including staying open on bank holidays.
GP leaders warned that the the plans drawn up by local A&E delivery boards – 18 of which have been investigated by Pulse – miss the ‘vital role’ of general practice while relying heavily on practices to increase access.
For example, winter plans in NHS Surrey Heath CCG include an intention to offer extended GP hours, including opening on bank holidays.
While the plan from West Essex Health and Care details the set up of six GP extended access hubs open on evenings and weekends.
The hubs will provide 225 hours of GP and nurse appointments per week and could be commissioned on the bank holidays over Christmas and Easter.
However, none of the plans detail any extra funding for primary care this winter.
This is in contrast to hospital trusts, which have received three waves of national funding this year – totaling £100m – to set up a ‘front-door streaming service’ in every A&E department.
But trusts are already struggling this autumn, with four declaring black or red alerts in September and October, and GPs have said the strain on A&E will put general practice under even more pressure this winter.
Yet the only national funding promised to general practice is a reinstating of the winter scheme to reimburse indemnity for extra out-of-hours shifts by GPs and a £10m extension of the flu vaccination scheme to include care home workers.
Dr Anu Rao, medical officer at Leicester, Leicestershire and Rutland LMC, told Pulse this was ‘too little too late’, adding that she was told by NHS England and her CCG that ‘there is no extra funding at all’ for in-hours GP care.
She said: ‘I think this winter is going to be very hard on us so we’re already anticipating extra appointments, but I still don’t think we’ll be able to cope.’
Lincolnshire LMC medical director Dr Kieran Sharrock agreed, saying ‘local commissioners seem to forget the vital role’ of GPs, adding that the plans for his area ‘seem very hospital focused’.
This comes as the NHS is bracing for the worst flu season in decades.
Dr Richard Vautrey, BMA GP committee chair, warned that this winter practices have ‘little or no spare capacity to deal with a serious flu outbreak or additional requirements on their services’.
An NHS England spokesperson told Pulse the £2.4bn extra promised each year by 2020 in the GP Forward View is evidence of its support for primary care, adding that ‘local winter contingency plans are just that – local decisions’.