Extended hours to differ across UK

Health departments disagree on whether longer opening is a priority for general practice.

Targets for extended hours are likely to differ across the four UK countries because the different governments disagree on their importance, GP can reveal.

Scotland's government will follow the DoH's push for extended hours, but in Wales and Northern Ireland (NI) the issue is not a priority.

In England, £158 million from the access and choice and booking directed enhanced services (DESs) will be re-invested as an extended hours DES. In Scotland £10 million is available for longer opening.

Scotland's Department for Health and Wellbeing confirmed that it would be following England's stance on improving access by re-allocating funding towards extending hours.

Any proposed changes to the quality framework by the DoH will apply across the UK from April because framework policy-making is not devolved.

GPs are being consulted on the reassignment of 58.5 quality points for a range of improved access, including extended hours.

Any DES arrangements in Scotland, Wales and NI will be negotiated by their own regional governments.

Extended hours negotiations are complicated because the current DESs vary across the four countries.

Dr David Bailey, GPC Wales chairman, said access was not an issue in Wales and he hoped to negotiate a separate deal.

Dr Brian Dunn, chairman of the NI GPC, said that extended hours was not a priority and he believed negotiations would be non-confrontational and that it would be possible to redirect funds into 'clinical, evidence-based areas'.

In December, the DoH moved to impose changes to the GMS contract with a 13-week period of notice, unless the profession accepted its final offer. The imposed contract would apply UK-wide and has severe terms that include removing 135 quality framework points worth £17,000.

But GPC chairman Dr Laurence Buckman warned the money would be handed to primary care organisations, with no guarantee it will be spent on access, and could result in GMS and PMS practices competing for the funds with APMS providers.

Next month he will ask GPs whether the DoH deal should be accepted.

View Dr Buckman's letter

GMS CONTRACT CHANGES ACROSS THE UK
Northern Ireland
Possible DES talks and 58.5 quality points reassigned but extended hours 'not a priority'. Hope to reassign freed funds to clinical areas.
Scotland
£10 million funding available, likely to include access DES, and 58.5 quality point reassignment.
Wales
Possible DES talks and 58.5 quality points reassigned but extended hours not an issue.
England
£158 million from access and choice and booking DESs available, plus 58.5 quality points reassigned.

tom.ireland@haymarket.com

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