Practices 'bullied' into longer opening hours

Practices are being pressurised to open extended hours without payment, according to the GPC.

PCTs are also using PMS contract reviews to insert extended hours into contracts.

Current discussions between the GPC and NHS Employers may create a national or directed enhanced service to support GPs who offer extended hours.

GPC negotiator Dr Stewart Drage said: 'We are concerned that practices don't get bullied into extended hours just because the government wants it. Enhanced services should pay for the cost of opening later, which should be worked out by the practice.'

GPC chairman Laurence Buckman said: 'This needs to be an extra-contractual agreement because any practice that accepts this would pave the way for it to be integrated into GMS.'

Highland Medical Centre, in Fareham, Hampshire, opens until 8pm once a week for a 'commuter clinic' for no extra funds. Dr Donal Collins, a GP at the practice, said it felt under pressure from the government.

'We were afraid of everyone saying "no" and someone like Boots doing it instead and taking our patients. We decided to stop a vacuum being created that might be filled by someone else.

'We know that extended hours opening is going to come in eventually. We decided to organise ourselves and get on and do it,' Dr Collins said.

Dr Buckman said there were some local enhanced service (LES) deals but elsewhere practices were pressurised to open longer without extra payment.

'Where it is disadvantageous to patients or the practice, or where the LES is clearly not going to move to a national level, we don't think practices should be taking part,' he said.

Any practice that felt pressure to open extended hours, should speak to its LMC, he added.

The GPC also believes that £250 million has been set aside for the 250 new health centres Lord Ara Darzi proposed and that all could be on APMS contracts.

Dr Buckman said: 'The government is clearly not interested in PMS or GMS.'

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