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GPs must be consulted on 12-hour opening

GPs in my area breathed a sigh of relief last month after convincing our CCG not to make us earn back lost income by working seven-day weeks.

Thanks to our campaign, NHS Wirral CCG ditched plans to roll out a £3m ‘Primary Care Access Scheme’, which was part-funded by £1.4m worth of decommissioned LESs.

Wirral CCG controversially decided to roll out its Primary Care Access scheme (PCAS) for 8am-8 pm working, seven days a week, at a cost of approximately £3 million.

The potential loss of £1.6 million from the local health economy because of the decommissioning of established LES’s, threatened to destabilise practices as well as disrupt the excellent patient care these enhanced services provided. Local GPs were worried: they had has no effective consultation with the CCG about the new scheme.

Only 250 out of our 300,000 patients had been surveyed about the scheme and neither questions and statistical analysis, met acceptable standards for such a huge scheme. No quality impact assessment had been done or communicated prior to the decommissioning of the Local Enhanced Services, and worst of all there was no evidence of benefit to patients or to the Wirral health economy as a whole.

With this transfer of in-hours practice funding to extended hours, it seemed that the CCG was expecting an already overburdened general practice to provide extra services over 7 days effectively without any new investment – for free.

A survey by the local LMC had a massive and unprecedented response. The survey found that GPs were concerned that they were being asked by their CCG to provide 7 day care, which has no contractual basis and which they felt unable to provide given the funding proposals, issues with recruitment and retention of GPs, and the increasing demands of their in-hours care.

By contract, CCGs in the surrounding areas have employed different measures to improve patient access and are investing heavily in core hours access.

In an LMC meeting, it became apparent that the CCG lacked the support of the majority of the GPs present, with respect to the both the proposal and the lack of prior engagement with GPs in both their commissioning and provider roles.

Member organisation?

After delaying the rollout, which had been scheduled for April, the CCG has now said it has ‘no plans’ to go ahead with the scheme.

The CCG was apologetic and recognised the fact that GPs were unhappy. But I had to remind them again that this is a member organisation, they are representing us, not the other way around. It is not the bad old days of the PCTs when they told us what to do.

I have always been a huge admirer of the Lansley ideology ‘No decision about me, without me’. But in this instance, Wirral CCG failed to adhere to this.

Episodes like these highlight the importance of the LMC in representing GPs (both commissioners and providers), as well as fundamental issues of communication and engagement between patients, GPs, and the CCG.

Dr Ivan Camphor is a GP in the Wirral, and medical secretary of Mid-Mersey LMC.