PCTs proving flexible over GP extended hours

GPs are being offered flexible surgery hours and extra financial incentives to provide later appointments.

PCTs are allowing GPs to provide extended hours in a more flexible way than expected.

Some PCTs are supplementing the direct enhanced service (DES) with additional payments to make the deal more attractive, said GPC negotiator Dr Chaand Nagpaul.

The GPC said the success of the extended hours DES depended on PCTs allowing practices to shift appointments around during the day.

There are still unresolved flaws in the DES that would put practices off, and it is not financially attractive, explained Dr Nagpaul.

'The government is at risk of not achieving its own target,' he said. 'When practices work out the expenses many will realise it is not worth their while.'

However, in many areas PCTs are offering local enhanced service (LES) payments to make extended hours more attractive to practices, he added.

Dr Harry Yoxall, chairman of Somerset LMCs, said it had worked out a LES arrangement with the local PCT.

'As ever, the PCT is looking to be as flexible as possible. The idea of hour-and-a-half blocks and no concurrent working is something we can look at,' Dr Yoxall commented.

'If all our patients want Saturday opening we'll have two GPs on a Saturday.'

Dr Yoxall thought many town practices would participate, but rural areas would not be so keen because demand was low.

'GPs are wondering if it is worth it if they only lose a couple of hundred quid,' he said.

'However, the PCT will have to provide it somehow; and GPs don't like the idea of private contractors being brought in instead.'

Dr Nigel Watson, chairman of Wessex LMCs, said he thought a large number of practices would take up the DES.

'The eight PCTs I cover have been quite flexible so far,' he said. 'I don't think the argument is about the number of appointments, it's about opening hours. We're talking about 18 extra appointments - I don't know what all the fuss is about.

'It's workable if PCTs will be flexible about concurrent work-ing,' he added. 'Many larger practices will find it is ridiculous if not.'

Suffolk LMC chairman Bill Robinson said because of the recent budget cuts from their PMS review, PMS practices will want to bring in income in other ways.

Mr Robinson was very positive about making the DES workable.

'The health service has a history of taking government initiatives and making them work,' he said.

tom.ireland@haymarket.com

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