One in seven practices could face longer opening to avoid £8,000 loss under new contract

One in seven practices could lose more than £8,000 a year on average from April unless they open for longer under the 2017/18 GP contract.

The 2017/18 contract announced on Tuesday introduced an additional requirement for the extended hours DES, which makes practices that close during core hours potentially ineligible for the funding.

NHS England said that from October practices that regularly close during core hours will not usually qualify to deliver the extended hours DES.

The GPC has suggested that the change will affect only a small number of practices. It said only practices that close for half a day on a weekly basis could be affected, while local exceptions may apply for branch or rural practices and for monthly training closures.

But recent figures from a National Audit Office report that prompted the government’s crackdown on core hours closures suggest around 14% of practices in England - over 1,000 practices - could be caught by the new rules. It said 18% of practices closed at or before 3pm on at least one weekday, with 76% of them receiving funding through the extended hours DES, earning an average of £8,224.

GP access

GPC deputy chair Dr Richard Vautrey said he would be ‘very surprised’ if that many practices were hit by the changes, but he said no details had yet been agreed with NHS England on defining half-day closures. ‘This is a high level agreement as it stands at the moment,’ he said. ‘That detail will need to be looked at. But the principle is everybody knows what a half day looks like and that is what we are going to be focusing on.’

‘Ultimately it would then come down to a decision for practices as to which one they chose to do, whether they continue to close,' he added. ‘This isn't forcing any practice to change their working arrangements. If they want to continue with half-day closing that will be their choice. They would have to make a decision about the cost-benefit about doing the extended hours or not.’

Dr Vautrey added: ‘This is as much about patients being able to walk in to pick up a prescription or to make an appointment at the reception desk as it is about anything else. So I think there are different ways practices can make themselves available that suits their population.

‘The NAO clearly identified a concern and I think the agreement is to try to address that but in a way that is appropriate and proportionate.’

The NAO report published in January ignited a political row over GP access. Prime minister Theresa May was accused of ‘scapegoating’ GPs for the NHS crisis after Downing Street officials suggested practices were failing to provide the access that patients need.

The RCGP has called for clear guidance on opening hours required from practices under the extended hours DES. The college warned that the deal 'must not be seen as a lever to force practices to compromise patient safety and GP welfare by opening at impractical or unrealistic times'.

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