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GPs defend opening hours

NHS England plans to end routine half-day closures to boost access

Mark Gould

Tuesday, 20 August 2019

GPs have defended opening hours as new plans from NHS England include a promise to end routine half-day practice closures and boost appointments outside core hours.

NHS England says practices will now have to ask permission from local Primary Care Networks (PCN) to close during core hours, or face losing funding as part of the expansion of primary and community care set out in the NHS Long Term Plan.


NHS England estimates that more than 700 surgeries shut for part of the week. Figures released by health officials show that seven practices open for 15 hours a week- 37.5 hours lower than 52.5 contracted weekly hours. And it estimates the plans could create up to 287,000 more GP appointments a year, with half-day closures reducing available GP time by around one million hours.

Under the network contract Directed Enhanced Service (DES) introduced as part of the five-year GP contract this year, practices need official approval for half-day closure. The DES says: "Unless a GP practice has prior written approval from the commissioner, no PCN member GP practice will be closed for half a day on a weekly basis and all patients must be able to access essential services, which meet the reasonable needs of patients during core hours, from their own practice or from any sub-contractor."

GP practices that close their doors during core hours without putting in place alternatives for their patients could lose their share of funding worth over £200,000 for an average sized network, which is typically made up of five practices.

British Medical Association GP committee chair Dr Richard Vautrey said it was "disingenuous" for NHS England to be so categorical in claiming they know exactly how many more appointments would be available if practices changed their opening arrangements.

“NHS leaders must work to address the ongoing recruitment and retention crisis to bring about lasting improvement to patient care and avoid putting overworked doctors under further strain."

And Royal College of General Practioners chair Professor Helen Stokes-Lampard also said it was "disingenuous" to suggest GPs were "shirking their responsibilities to patients".

"We want our patients to be able to see a GP or member of the practice team when they need to - and it is as frustrating for us as it is for them when they have to wait too long for an appointment. Indeed, it is testament to the hard work and dedication of GPs that we are consistently rated as highly-trusted amongst patients, despite this.

"On occasions when practices are closing during routine hours, it is not time 'lost' to patients, it is usually time spent conducting telephone or online consultations, or making home visits - or some of the other many vital tasks that GPs and our teams are required to do, such as complying with mandatory or statutory training."

She added that it was more likely that "branch" practices affiliated to larger sites that have regular closing hours - or very small practices that are forced to close due to staffing shortages.

"In either case, adequate cover arrangements will always be put in place for patients who need urgent care and, wherever possible, patients are fully informed well in advance, and explanatory messages are posted on websites and surgery answer machines."

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