LMC issues contract breach ultimatum over claim GP must be on-site in PCN enhanced hours

An LMC has rejected claims that a GP must be physically present throughout PCN enhanced access hours - and challenged NHS England to issue practices with breach of contract notices if it is wrong.

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GP practice (Photo: mtreasure/Getty Images)

Last week NHS England clarified that, from October, PCNs will need to have a GP available to see patients face-to-face during enhanced access hours, including between 9am and 5pm on Saturdays.

An NHS England spokesperson told GPonline on background that this meant a GP would have to be physically present during these hours, adding that it was ‘already the case in many parts of the country’. It followed widespread confusion around the wording of the contract.

However, Cambridgeshire LMC has argued that a GP does not have to be present during enhanced access hours because there is no requirement in the core contract for a GP to be present at all times during contracted hours.

Enhanced access

As an extension of the core contract, Cambridgeshire LMC says that the PCN DES also does not require a GP to be physically present - and insisted the presence of a GP should be determined by practices and their patients.

Disputes about whether a GP must be on site at all times to supervise enhanced access hours in the PCN DES comes as the deadline to opt out of the contract passed on 30 April, with a number of practices indicating that they would continue with the work.

In a newsletter to GPs, Cambridgeshire LMC said: ‘The core contract does not say a GP has to be on the premises at all times during the contracted hours. By extension, therefore, a GP does not have to be present during [extended access] hours.

‘Again, given that not all consultations need to be face-to-face, by definition, that also means a GP doesn't have to be on the premises at all times. We would advise practices and PCNs to continue to deliver services which they believe meet the reasonable needs of their patients and their contractual obligations.’

Contract breach

It added: ‘Clearly if NHSEI or CCGs believe they aren’t, then they will issue breach notices which will have to specify which clause(s) of their contracts they are in breach of, and why. If practices aren’t in breach, such notices will be easily challengeable.’

Under contract changes imposed by NHS England for the 2022/23 GP contract, general practice will be expected to deliver a minimum of 60 minutes of appointments per 1,000 adjusted patients per week in 'network standard hours' - from 6.30pm to 8pm and 9am to 5pm on Saturdays.

Responding to confusion around requirements for a GP to be on-site during extended access hours, an NHS spokesperson said: ‘From October all PCNs will be required to ensure a GP is available to see patients face-to-face on Saturdays between 9am and 5pm, as is already the case in many parts of the country.’

GPs will debate calls to reduce general practice core hours from 8am-6.30pm to 9am-5pm and to build safe workload limits into a revamped GP contract this month at the UK LMCs conference.

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