GPs priced out of running out-of-hours services, warns RCGP

Ministers should make it easier for GP practices to take control of out-of-hours services, the RCGP has said, warning that many are being 'priced out' by large private providers.

Dr Maureen Baker: GPs priced out of out-of-hours services
Dr Maureen Baker: GPs priced out of out-of-hours services

In a report published on Tuesday, The Future of GP Out-of-Hours Care, the RCGP said practices were being ‘priced out’ of the market by a tendering process that makes it difficult to compete with large private providers.

The college also called for better integration of out-of-hours care with 111 services and better sharing of patient information across the emergency and urgent care services.

RCGP chairwoman Dr Maureen Baker said GPs are keen to provide more out-of-hours services. But she added: ‘Those who are bidding for new out-of-hours contracts can find it difficult to compete on cost with bigger companies, some of which have little or no local GP input and involvement with the communities where they want to run services.’

She said: ‘GPs play a central role in their communities and many are well placed to provide care to patients outside normal hours. The recent report by the CQC and the latest independent GP patient survey report very high levels of satisfaction among patients who saw a GP out of hours, both for the timeliness and the standard of care they received.’ 

She added: ‘This is not about a return to all GPs working round the clock – that would be unsustainable for GPs and unsafe for patients.

‘But if GP practices wish to work together to provide out-of-hours care for patients over large geographical areas, they should be given every encouragement to do so - and they must not be held back on the grounds of cost.’

Recommendations in the report:

  • DH should clarify the legal position of GPs seeking to opt back into the provision of out-of-hours care, and make legislative changes if necessary to ensure that they are able to do so without the requirement to go through a competitive tendering process.
  • Make integration between different parts of the health service a key consideration when developing new out-of-hours services.
  • Remove barriers that prevent providers of out-of-hours services from accessing patient records.
  • Review national standards and specifications for out-of-hours GP services and NHS 111 to ensure integration.
  • Increase GP training from three to four years to allow trainee GPs to gain more exposure to out-of-hours services, such as emergency care.
  • Introduce a requirement to consider the ability of services to provide training sessions and supervision as part of the clinical commissioning process in England and according to other arrangements in the devolved nations.
  • Ensure that proposals to enhance the provision of extended hours GP services are adequately costed and funded.

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