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PM7dayOctober 7 2015

GP leaders have queried how a new voluntary GP contract providing for service seven days a week will work.

On Sunday, the Prime Minister announced there will be a voluntary contract option for general practice which will end “micro-management” of GPs’ work through the Quality and Outcomes Framework, along with other bureaucracy which will be scrapped.

As part of a new “patient guarantee” the Prime Minister announced that NHS England and clinical commissioning groups will be required to ensure that every patient has access to seven-day services by 2020 in primary and by 2018 in secondary care.

The announcement also made reference to a new study by the Primary Care Foundation and NHS Alliance which “sets out a number of ways of reducing bureaucracy – including by allowing smoother rebooking of appointments, sharing best practice, and linking more effectively with nurses and pharmacists.”

Under the terms as set out by the PM, “the new contract will be voluntary, with federations or practices that cover populations of at least 30,000 patients.

“GPs who choose to join it will continue to work in local neighbourhood surgeries and health centres, with all the traditional benefits of family practice. But they will now be able to join forces with neighbouring GPs to form these federations and networks of practices – allowing them to deliver better integrated care and work more closely alongside community nurses, hospital specialists, pharmacists and other health and care professionals.”

Responding to the announcement, RCGP Chair Dr Maureen Baker said the PM being interviewed on the BBC by Andrew Marr had “caused even more stress and worry for the country’s dedicated and hardworking GPs who are already going all out to provide safe care for their patients with ever-dwindling resources.

PM7day2“We have since learned that the new contract will be voluntary, and we understand there are to be future announcements on resources, but at this stage we question whether enough will be done to support general practice across England. Seven day access may be a lofty political aspiration but at a time when general practice is already creaking at the seams, we do not think it is a good use of NHS resources to be offering ear syringing on a Sunday teatime.

“We need detailed answers to how this 'voluntary' contract will work and how it will be funded.”

Dr Chaand Nagpaul, BMA GP committee chair, commented: “Yet again, the government has chosen to rely on soundbites during the Conservative Party conference rather than actually addressing the fundamental issues facing general practice and patient care.

“This announcement, which was not discussed with the BMA, does nothing to address the root causes of the pressures on general practice; escalating patient demand from an aging population and care moving into the community, crippling underfunding and a chronic shortage of GPs.

“The government must learn from its own pilot schemes where there have been a number of examples of weekend appointments having little or no pick up by patients. These proposals could waste precious NHS resources and divert staff and funds from overstretched core GP services.”

A second statement from the BMA called for further answers to questions about how seven-day services will be staffed and funded, “given the shortage of doctors in many parts of the NHS and the extreme funding pressures facing many trusts.”

Dr Mark Porter, BMA council chair, said: “Given the current funding squeeze on NHS Trusts, the only way for many hospitals to increase the number of doctors over the weekend would be to reduce the number of doctors providing elective care during the week.

“It is simply not going to work if the government expects hospitals to stretch the work currently done Monday to Friday over seven days. The fact that hospitals preparing for the introduction of seven-day services require dramatic increases in senior doctors exposes the potential risks to patient care of rushing to make changes with the necessary plans and resourcing in place.”

Links:

Prime Minister’s announcement

Primary Care Foundation and NHS Alliance report ‘Making time in general practice’

RCGP response

BMA GPC comment

BMA Council comment

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