Practices warned of 'conditional' extended hours

GPC urges practices to reject offers of late opening where PCTs make core-hour demands.

Practices whose PCTs try to force them to do more in-hours work before offering extended hours funding should say no to late opening, the GPC says.

The advice comes after Berkshire LMC overturned a decision by NHS Berkshire East to withhold offering the extended hours directed enhanced service (DES) until all practices were open throughout core hours.

The LMC said the trust wanted 'all practices open from 8am to 6.30pm with telephones on and the doors open before issuing the DES'.

Dr Paul Roblin, chief executive of Berkshire LMC, said that several months of wrangling had ended two weeks ago.

'We impressed upon it the need to comply with a nationally agreed obligation. It could not delay offering the DES,' he said.

Dr Roblin said the LMC had threatened to complain to the SHA. 'That was one of the levers, but ultimately we convinced it that it was in default of its obligation,' he said.

'The (DoH) guidance said that extended hours had to be additional. You can't link in-hours and extended hours,' he said.

If the PCT felt in-hours were inadequate it should discuss this with practices, he added. 'It should not stop it sanctioning extended hours,' he said.

GPC deputy chairman Dr Richard Vautrey said practices should say no to PCTs that tried to make extended hours incentives conditional on in-hours opening times.

'If it's a target for the PCT, just don't do it and wait for it to come back with something better,' he said.

Some PCTs offer local enhanced services to boost in-hours opening, he said. Most PCTs now accept they cannot withhold the extended hours DES, he added.

Jacky Walters, assistant director of primary care at NHS Berkshire East, said: 'Best practice is full open-door access for all contracted hours.

'Practices that do not meet this requirement will need to show that they can still meet the needs of their population.'

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