GPC warns extended hours means 12-hour days for GPs

GPs face working 12-hour days under the new extended hours DES arrangement in England.

Practices will not be allowed to move consultation time from the day to the evening or weekends to give GPs time off.

Further details of how the extended hours DES will work were released after GPs reluctantly accepted the governments offer.

GPC chairman Dr Laurence Buckman hopes that PCTs will be flexible, as extended hours could be achieved easily if GPs could shift appointments around.

Therefore the GPC is still advising practices not to participate in a PCT audit of the appointments they offer. This will make it harder for PCTs to assess if GPs are working fewer hours in the day when the extended hours DES starts.

GPC deputy chairman Dr Richard Vautrey said a lack of flexibility in the current agreement meant GPs would be working from 8am until 8pm. ‘That cannot be good for patient safety. Tired doctors are more likely to make mistakes,' he said.

The GPC called for PCTs to be reasonable and to work with LMCs on the implementation of the DES.

The agreement with NHS Employers was announced alongside the results of the GP poll of opinion, which showed nearly all (97 per cent) GPs lacked confidence in the government's handling of the NHS.

The poll also showed an overwhelming majority of GPs (98 per cent) thought the government's methods of negotiation were unacceptable. But although 96 per cent of GPs were opposed to both options, 92 per cent voted for option A, which means the average practice will lose £18,000 unless it participates in the DES.

Scotland will begin work on implementing a slightly different version of the DES after discussions between PCOs and contractors establish local need.

Northern Ireland has negotiated an improved clinical DES instead of extended hours. Wales is negotiating to do something similar.

 Extended hours DES in England
  • Practices will receive £2.95 per registered patient, taken from the former Choice and Booking DES.
  • The DES requires that for every 1,000 patients, 30 minutes additional consultation time must be offered outside core hours.
  • Consultation time must be in blocks of 1.5 hours, except where PCTs agree one hour prior to 8.00am is suitable.
  • This equates to 6-7 consultations per 1.5 hour block.
  • GPs cannot work together to fulfil these requirements in a shorter space of time (except in very large practices)
  • If a practice currently closes for part of the day this does not have to be made up before extended hours can commence.
  • Practices already offering consultations outside core hours will be able to count these towards the DES.
  • Nurses will not be recognised under this DES.
  • Payment will be quarterly; list size will be calculated on 1 April 2008.

What the poll outcome means for your practice

BMA's GP poll results

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