Contract Special - Extended hours negotiations continue

GPC resolution favours DoH contract deal as practices warned not to divulge appointment details.

The GPC is still looking at 'fundamental flaws' in the planned directed enhanced service (DES) for extended hours, despite passing a resolution apparently favouring the DoH offer last week.

As negotiations on the wording continued this week, GPC chairman Dr Laurence Buckman said 'significant movement' from the government helped the GPC to conclude that the offer was preferable to the threatened imposition if it was rejected.

But GPC members have questioned whether the letter from NHS Employers at the centre of the GPC's decision contained any meaningful detail.

GPC member Dr Prit Buttar said a large majority of GPC members had voted to back the offer but that he doubted there was anything in the NHS Employers letter that had significantly changed the deal.

'I think the wording was subtly different, but there wasn't anything that would have made a material difference,' he said.

The eight-hour meeting was the longest that he had attended in three years on the committee, he added.

GPC chairman Dr Laurence Buckman said: 'There has been a clamour for us to give guidance. The government has moved sufficiently for us to say this will do you less damage.'

Details of the DES for England confirmed so far suggest £2.95 per patient per year will be paid to practices for opening for an extra half an hour per 1,000 patients.

Opening times will depend on how many patients want Saturday surgeries and how many weekday evening opening.

A further 58.5 quality points will be re-assigned to rewarding access and the DoH has offered a guaranteed 1.5 per cent increased investment in general practice.

GPC negotiator Dr Chaand Nagpaul said there were fundamental flaws with the DES.

'The rigid terms do not factor in the variable demand for extended hours. Some practices will have such small demand that it will be hard to justify opening.'

It is unclear how practices that have no demand for extended hours will recoup money re-invested into the DES, which equates to a loss of £18,000 for the average practice.

Dr Nagpaul said the GPC also does not know whether practices will be allowed to reduce the number of appointments they provide during the day to better enable extended hours to be offered.

He hoped that the government could clarify this before GPs are polled on their opinion later this month.

GPC Resolution

'The GPC has come to the conclusion that Option A is less damaging for general practice, because the alternative option will harm the underlying fabric of NHS general practice and patient care more quickly and more lastingly.' 

tom.ireland@haymarket.com

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