The DoH has said some local enhanced services (LESs) will not count towards PCTs' target of getting 50 per cent of practices opening extended hours, say local GP negotiators.
Dr Grant Ingrams, secretary of GPC West Midlands, said he had heard it reported around the country.
‘PCTs are telling us they are under a lot of pressure. One chief executive told me, but asked not to be quoted, that it is being told: ‘you are not allowed any imagination here'.'
Dr Nigel Watson, chief executive of Wessex LMCs, said the DoH had briefed SHAs not to allow concurrent working for practices with fewer than 12,000 patients and to stop GPs being paid monthly rather than quarterly.
The 139 practices in the South West that have signed up to a LES would have trouble ‘unpicking' the four-year deal, said Dr Watson.
It is unclear how many practices around the country may be affected, but a recent GP survey showed 94 per cent of PCTs had developed a LES that differed in some way from the directed enhanced service interim guidance (DES).
PCTs across the West Midlands and Wessex maintain the LESs are working well and deny they have been told to tighten up the terms.
A spokesman for the DoH said there was no ‘official requirement for GPs to comply' with their original recommendations.
The final extended hours directed enhanced service is expected to be published in October.
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