Pay practices to support GP out-of-hours care, say urgent care leaders

Urgent care leaders have said a new enhanced service could pay practices for their GPs working shifts in out-of-hours services.

GP Dr Simon Abrams, chair of the umbrella body for non-profit out of hours organisations Urgent Health UK (UHUK), has said a new enhanced service could help restore the link between practices and urgent care providers.

The proposal came as Jeremy Hunt earlier this week called for NHS bosses to consider freeing up time for GPs to support urgent care work. Mr Hunt made the suggestion in an emergency statement to the House of Commons on Monday about the winter crisis engulfing parts of the NHS.

But the GPC has dismissed the suggestion of a new enhanced service as unnecessary, because CCGs are already able to commission additional capacity.

GP out-of-hours care

Dr Abrams said his organisation, which represents GP-led, social enterprise unscheduled primary care providers, would consider developing the proposal after members reported continuing recruitment difficulties. Providers have said that they face problems filling sessions despite some relief from NHS England’s £30m winter indemnity programme.

GPonline reported this week that providers have reported year-on-year demand increases of up to 15% in recent weeks.

Meanwhile, a scathing National Audit Office report on government plans for seven-day GP services warned that extended hours schemes were competing for the same staff that work in existing GP out-of-hours services, and providing services that overlap with the out-of-hours service.

Dr Abrams said UHUK members have said it would help the service if in-hours GPs were encouraged to work a shift a month for their local out-of-hours provider. ‘I thought that was an interesting suggestion as a means of trying to address the workforce issues,' said Dr Abrams.

He suggested an enhanced service to encourage GPs to work an out-of-hours session. ‘It leaves it optional but puts it into the mainstream,' he said.

GP enhanced service

Dr Abrams said an enhanced service with indemnity cover attached could help bridge the gap between practices and out-of-hours providers. ‘Because out-of-hours are still quite isolated organisations that, although providing primary care with GPs who frequently are doing the in-hours jobs as well, so they are local GPs, they still are quite separate services.’

The urgent care leader said UHUK would ‘certainly be willing and interested’ in developing the proposal. ‘If NHS England wanted to consider an enhanced service of that nature, that might well be something that might get local GPs, because if it was an enhanced service it would have to be practices.’

He added: ‘Daytime GPs will say they have lots of work to do in-hours, and so asking them, to do out-of-hours sessions as well is a big ask. And agree with that. Daytime GP remains very much under pressure.’

GPC deputy chair Dr Richard Vautrey said a new enhanced service was unnecessary. ‘CCGs can already fund additional out-of-hours capacity when it's needed,' he said, ‘but the best way is to fund the out of hours provider properly to enable them to have the necessary capacity to meet local demand for their services.’

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