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GP occupational health services in jeopardy as NHS Commissioning Board reviews funding

Exclusive GP occupational support services are in danger of having their funding removed after the NHS Commissioning Board decided to review all their contracts, with CCGs in some areas forced to step in to ensure they continue after April.

Pulse can reveal that at least four CCGs have decided to take on the funding of existing services providing health and wellbeing support to GPs, as the NHS Commissioning Board conducts a review of current services.

The Board says it has no statutory responsibilty to carry over such services, but RCGP chair Professor Clare Gerada says that it would be a ‘false economy’ to get rid of the services for GPs.

Pulse contacted all PCTs in England regarding the future of occupational health services for GPs post-April and some 22 PCTs responded.

Of those, only three areas - Hertfordshire, Stockport and Doncaster - could confirm their services for GPs would continue as the local CCGs were planning to continue funding them, a total of four CCGs.

Around half of respondents did not provide any services for GPs at all, and the remainder said the continued presence of occupational health services depended on the NHS Commissioning Board and its local areas teams deciding to take them on from April.

A spokesperson from the Board said it was currently reviewing the services that have been provided in some areas by PCTs. He told Pulse: ‘It is not a regulatory requirement for the Board to provide occupational health services to GPs and their staff.

‘At the moment we are looking at who has done what in the past. PCTs submit a list of services they have provided, including occupational health. There is work being done to have a look at it.’

The review of PCT services comes after LMC leaders said spiralling practice workload had led to ‘shocking’ numbers of GPs requiring pastoral help as many struggle to cope with work-related stress and burnout.

Professor Gerada said she was ‘sad’ that there was a question mark hanging over these services.

She said: ‘A lot of regions won’t provide them because they are seen as expensive. But that will be a false economy because it means GPs will take longer to get back to work when they are absent.

‘Some people will argue that GPs should fund occupational health services themselves because they are independent contractors, but asking them to do that means it is one more issue to deal with at a time when practitioners are struggling. GPs really benefit from confidential help and support to return to work.’

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Professor Gerada has lobbied in the past to improve occupational health services for NHS workers and highlighted the 2009 NHS Health and Well-being Review by Dr Steve Boorman, which said that the NHS must invest in the health of its workforce to ‘deliver sustainable high quality services.’

In 2009, the NHS Constitution introduced the pledge that the NHS would ‘provide support and opportunities for staff to maintain their health, well-being and safety’ after the Government pledged to tackle the hidden problem of depressed doctors. At the time, The Doctors’ Support Network estimated that around 25 GPs a year commit suicide.

Sefton LMC chair Andrew Mimnagh said he had been lobbying hard locally to ensure the local occupational health service for GPs was retained, and had a verbal agreement that it would be from the LAT.

He said: ‘I suspect most LMC’s are anticipating increased demand for pension, clinical, probity and fitness to practice support or guidance with the looming contract imposition. I would urge every LMC to confirm the service will roll forward in line with historical provision, and that any recommissiong is to the same or improved specification.’

Dr Peter Swinyard, chair of the Family Doctors Association, said that the Department of Health had made a committment to fund GP occupational health services that it should honour.

He said: ‘This was a Government commitment in 2003-04 based on the provisions of the NHS Plan in 2001. It’s absurd to dump this back onto GP as our problem.’

Dr Richard Vautrey, a GPC negotiator, said: ‘We are concerned about this and are raising it directly with the NHS Commissioning Board. We fought hard to get occupational health support for practices and eventually DH committed to providing this through PCTs. It is a service that has been important for many practices and their staff. This must not be lost as part of an overly hasty transition.’