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CCG scraps clinical services while funding £3m extended hours scheme



Exclusive: A CCG is scrapping £1.4m worth of clinical local enhanced services at the same time as funding a new ‘extended hours’ enhanced service, despite widespread opposition from local GPs, Pulse has learnt.

NHS Wirral CCG plans to scrap local enhanced services for chronic kidney disease, vascular disease, end-of-life care, osteoporosis and diabetes from the 1 April in a move that has been criticised by local GPs.

At the same time, the CCG is investing £3m into a new extended hours ‘Primary Care Access Scheme’, which was due to begin at the start of April, but had to be postponed after further concerns from practitioners.

There has been controversy around the rollout of seven-day, 8am-8pm working, but this is the first row between GPs and CCGs over money for clinical enhanced services being put in to extended hours services.

The CCG said that the funding for the clinical services was stopped because of potential duplication.

A statement said: ‘The CCG discontinued investment in a number of historical schemes where there was a significant duplication in their specification with QOF and potential double payment. The cessation of these enhanced services had no impact on provision of these long-term conditions which form part of GP core contract and QOF. The value of these services equates to approximately £1.4m.’

‘Wirral CCG offered to reinvest these resources to boost the existing national DES and a Wirral LES for primary care access which has been in existence for many years. The expected outcome was to increase access between 8am-8pm on weekdays and up to four hours at weekends.’

However, Wirral GP and medical secretary of mid Mersey LMC Dr Ivan Camphor said that these clinical services are not part of a GP’s standard duties.

He said: ‘End of life and anticipatory treatment is being withdrawn, extended local diabetic treatment is being withdrawn and we are being told that “you will do this anyway because this is part of your QOF” – it isn’t part of QOF.’

He added: ‘There is a lot of obvious anger and disappointment in the CCG for not representing its membership organisations and deciding to go unilaterally with a seven-day working pattern which is not contractual and which is not based on any national agreed guidelines. That is the issue.’

Wirral LMC honorary secretary Dr Abel Adegoke told Pulse that Wirral GPs have ‘expressed…anger and opposition to the withdrawal of some LESs and the money that goes with it and also the Primary Care Access Scheme which was initially planned for Wirral GPs from 1st April 2014.’

Meanwhile, the CCG has postponed the rollout of the extended hours service because of concerns from local GPs about the timescales involved.

In a statement, the CCG told Pulse: ‘Wirral CCG has committed to work in consultation with its member practices and the LMC to explore how it can reinvest these remaining resources in primary care, in line with national and local priorities. The CCG is also committed to working with its member practices on how any further investments are best utilised for care of the elderly and managing patients in the community.’