This site is intended for health professionals only

Seven in ten GPs would not take back out-of-hours ‘at any price’

Exclusive Most GPs would not take back responsibility for out-of-hours care even if they were offered up to £20,000 per partner and had a guarantee they would not have to do the on-call shifts themselves, a Pulse survey reveals.

The survey of 400 GPs reveals the extent of the opposition in the profession to resuming any kind of responsibility for out-of-hours care, with 62% saying they would support the GPC in taking some form of industrial action if NHS England seeks to change the GP contract to do this.

The survey also found considerable opposition to RCGP proposals that the profession considers taking back responsibility for the out-of-hours care for the 5% of vulnerable patients on their lists – with 87% opposed to the idea.

Half of GPs said they would still reject taking back responsibility for overseeing the quality of OOH care for their patients, even if there was a guarantee they did not have to do on-call shifts themselves – 36% were in favour.

Some 69% of GPs said they would not take back responsibility for out-of-hours care ‘at any price’, although 23% said they would do so for £20,000 per partner annually and 5% said it would take £10,000 annually for them to change their minds.

The strength of the opposition is likely to prove problematic for the GPC, who have recently been hinting that they may agree to co-operatives of GPs resuming out-of-hours responsibility for patients.

The GPC recently dropped its opposition to RCGP proposals for GPs to resume responsibility for the 24/7 care of elderly patients or those with complex medical problems, after the college clarified the proposal would be for GPs working in federations or co-operatives to take collective responsibility.

The furore over out-of-hours care was sparked by health secretary Jeremy Hunt last month when he announced that he wanted GPs to be individually responsible for their patients around the clock and given a duty to ‘sign off’ out-of-hours care.

LMC leaders last month rejected the possibility of GPs taking personal responsibility for out-of-hours care at their annual conference, and grassroots GPs taking the Pulse survey went further, saying any kind of extra responsibility should be rejected.

Dr Mark Beecham, a GP in Maldon, Essex said: ‘Definitely not. It would be the thin end of the wedge.’

Another respondent Dr Thomas Bloch, a GP in Broadway, Worcestershire said this would mean practitioners getting the blame for problems: ‘This would be a recipe for disaster - we would get the blame for any shortcomings. This is the only reason the Government wants to be shot of it.”

Responding to the survey, Dr Mary Church, a GP in Blantyre, south Lanarkshire said: ‘This is an over my dead body issue.’

Dr Richard Vautrey, GPC deputy chair, said the survey showed that contractural changes were not required as CCGs now had responsibility for out-of-hours care.

He said: ‘GPs are fearful that this would place a contractual change upon their shoulders and those who say it´s the thin end of the wedge are right.

‘We need to be very careful about any attempt to increase the weight of responsibility on GPs and we don´t want to complicate commissioning arrangements via CCGs by doing so at a time when CCGs are just getting started.’

Dr Vautrey also said that ‘no-one is threatening’ industrial action. However, he added: ‘If the Government is mad enough to go down that road, industrial action would be the least of their worries. GPs would vote with their feet and leave the profession and then you´d have a crisis in in-hours care as well.’

In full: Results of GP survey on out-of-hours care