Extended hours row jeopardises UK contract

The UK contract is under threat because of the four governments' different attitudes to extended hours, GPs fear.

Alan Johnson
Alan Johnson
England: DoH bypasses BMA to persuade GPs
The DoH is trying to bypass BMA objections, and persuade England's GPs to accept the proposed contract.

If GPs in England reject the proposal, the DoH will impose a tougher contract, handing over 135 quality points and the choice and access directed enhanced services (DESs) to PCTs to fund extended hours.

Health secretary Alan Johnson has written to every GP in England explaining the DoH proposal to use £158 million DES money to pay for practices to open an extra 30 minutes per week for every 1,000 patients. The deal will also use 60 ‘redundant' quality points to improve access and give a guaranteed 1.5 per cent increased investment.

In a second letter, Mark Britnell, NHS director-general of commissioning, advised SHA bosses to prepare PCTs for extended hours, by beginning discussions with practices, and drafting local enhanced services agreements in case no national deal is agreed. 

Scotland: no threat of imposition
A contract will not be imposed upon GPs in Scotland if they reject the government's offer, despite hardline rhetoric from Westminster.

Dr Dean Marshall, GPC Scotland chairman, wrote to all GPs last week to say he has received ‘assurances that further negotiations would take place between GPC Scotland and the Scottish government' if the profession rejects the proposed contract.

 Such a move could be politically embarrassing for the UK government.

GPC negotiator Dr Peter Holden said: ‘Number 10 is petrified that Scotland may yet do its own thing, and there'd no longer be a national health service.'

The GPC is considering its next move in the event that a deal is agreed in only some parts of the UK.

The contract on offer in Scotland is almost identical to the one proposed in England, but with an extra £9.5 million to pay for extended hours.

Northern Ireland: Wants to accept proposed deal
GPs in Northern Ireland look poised to reach a deal on a new GMS contract, after the GPC Northern Ireland voted unanimously in favour of government proposals.

Dr Brian Dunn, chairman of GPC Northern Ireland, said: ‘It's important to get the details right, and we still plan to poll our members.

‘But we hope to be able to advise them to vote for the contract.'

The NI Executive proposes using £1.3 million from the £4 million access DES to fund aspiration payments to help set up improved access services. The remaining £2.7 million will be used to pay for a new clinical DES, in an area to be chosen at a meeting being held this week.

But the offer does not include the 1.5 per cent guaranteed funding increase proposed in England.

However, Dr Dunn added: ‘We've benefited from the UK contract, and want to retain it for as long as we can.'

Wales: extended hours not a priority
GPC Wales still hopes to reach a deal on extended hours acceptable to both GPs and the Welsh Assembly.

Extended hours are not seen as a priority in Wales because most people work close to home, making it easier to get an appointment during the day.

GPC Wales was meeting with the assembly to discuss more flexible ways of achieving the DES. These may include extending surgeries times by fewer hours, but on more days.

Dr Bailey also said he thought the Welsh Assembly was unlikely to impose a deal.


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