The contract regulations are perfectly straightforward. They require than when the practice is closed, patients have reasonable access to those contracted services that are necessary. There is no [GMS] contractual requirement for you to be open – either your doors physically open or your phones and receptionists available – all the way through core hours. There are still practices that take a half day, or close at lunch time. Until recently, PCTs and CCGs were actually funding practice closures for half day protected learning time.
The telling phrase is ‘reasonable needs’. We all know that from mid-afternoon on Christmas Eve, and to a lesser extent New Year’s Eve, no-one comes near the practice. We have all done those shifts where for some reason or another we couldn’t use out-of-hours providers in hours and some poor so-and-so sits there in the waiting room reading 20-year-old copies of Woman’s Own and absolutely nothing happens. No-one comes, no-one rings, it is absolutely dead.
So there is no point in maintaining ordinary services right through to 6.30pm on Christmas Eve. It is a complete waste of everybody’s time.
As long as practices ensure that they have contracted with an out-of-hours or some other service so they have a fall back, there is no reason why they should not give due notice to the contracting authority and close early.
We have taken that to BMA lawyers and they agree with our understanding.
We have contacted all our practices to let them know this is the case and we have the support of the GPC and the BMA’s legal department and we will support practices to the very limit, even taking it to the first-tier tribunal of the Family Health Services Appeal Unit if any practices are issued with breach notices or worse as a result of closing a little early on Christmas Eve and New Year’s Eve. It is a pointless exercise and it is mean-minded.
Dr Tony Grewal is medical director of Londonwide LMCs