GPC to negotiate minimum price for out-of-hours services

The government must set a minimum out-of-hours contract price to protect the quality of services and avoid a 'race to the bottom' on tendering, GPs have demanded.

Delegates at the annual conference of LMCs in London backed a motion that there must be a minimum contract price to address underfunding in out-of-hours services.

Dr Fay Wilson, medical director of GP out-of-hours co-op BADGER and Birmingham LMC member, warned that without a minimum contract price the tendering process for services would become a ‘reverse auction’ where price was the ‘critical factor’.

She said: ‘The tariff would address this and would go some way to creating a level playing field. If out-of-hours is to remain a wholly commercial, competitively tendered bit of the NHS then we must stop this race to the bottom of price competition.

‘You know out-of-hours matters because if it goes wrong our patients suffer, and GPs get the blame.’

Dr Bruce Hughes, a member of Devon LMC, said that out-of-hours services across the country were ‘desperately underfunded’.

‘They cover patients for two thirds of the week, and do so with as little as £81 per patient per year. It is a trifling amount. I insure my dog for more than that,' he said.

Dr Hughes said the quality of out-of-hours care will become more important as GPs take on commissioning, and made a call for a minimum contract value to be set.

‘Soon GPs as commissioners will have the opportunity to look hard at the commissioning of out-of-hours services,' he said. 'I hope they understand the need for quality and a level playing field.’ 


But Dr Brian McGregor, a member of North Yorkshire LMC, said it would be more appropriate to create a ‘robust framework’ to hold commissioners and providers of out-of-hours care to account.

‘We actually need to be very wary of a minimum contract price because it may not serve our patients very well,' he said.

The motion calling for a minimum contract price for out-of-hours services was passed by conference by 104 votes in favour to 87 votes against.

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