CCGs to get £6 a patient to extend general practice opening hours

BMJ 2016; 354 doi: (Published 23 September 2016) Cite this as: BMJ 2016;354:i5203
  1. Gareth Iacobucci
  1. The BMJ

Every clinical commissioning group (CCG) in England will be given recurrent funding of at least £6 (€7; $7.8) per head of population to allow GP surgeries to extend their opening hours, NHS leaders have announced.

CCGs will be required to commission at least an extra 1.5 hours of evening appointments after 6 30 pm on weekdays, but will have the flexibility to offer Saturday and Sunday appointments according to local need.

The BMA said that it was pleased that NHS England had accepted its argument that it was “a nonsense” to force GPs to open from 8 am to 8 pm on Saturdays and Sundays.

The funding will initially be released during 2016-17 in areas of England that have been piloting extended hours through the government’s GP Access Fund. This funding will be expanded to the rest of the country in 2017-18, with every CCG set to receive the additional money by April 2019.

In London the money will be deployed in 2016-17 to fund a larger scale, extended access programme covering the whole city, which will be led by NHS London.

The details have been outlined in new planning guidance from NHS England and NHS Improvement,1 2 which flesh out the commitment in the General Practice Forward View to release extra funds to GPs to enable routine appointments at evenings and weekends.3

The guidance says that extending and improving access to primary care is a “must do” for all CCGs by the end of March 2019, with the total investment in the scheme reaching £258m in 2018-19.

From April 2019 “every CCG can expect a minimum additional £6 per head to improve access to general practice,” NHS England said.

Richard Vautrey, deputy chair of the BMA’s General Practitioners Committee, said that it was a good thing that areas now had certainty on the recurrent funding available for extended opening but added that £6 a head was “much much less” than some pilot sites had been operating with.

He said, “Those sites will have to cut their cloth accordingly and either reduce the number of appointments or use a greater degree of skill mix to provide that extended service.” Vautrey added that the committee was pleased that NHS England had listened to its call for flexibility.

He said, “We’ve won the argument on the nonsense of expecting every area to provide 8 to 8 services on a Saturday and a Sunday. NHS England have clearly listened to that and ensured that there is flexibility in the guidance so that you can take into account the local needs of the population.”

CCGs will be required to submit plans for implementing the proposals set out in the General PracticeForward View by 23 December 2016, including details of how they plan to improve GP access, how they will apportion funds for practice transformational support, and how they will ringfence funding to train extra primary care support staff and facilitate online consultations.

NHS England has pledged that the total investment in general practice will rise to an extra £2.4bn in 2020-21 through the measures outlined in the forward view.

Maureen Baker, chair of the Royal College of General Practitioners, welcomed the guidance. “This is an important next step as we work towards tangible delivery of the pledges in the General Practice Forward View,” she said. “This is particularly significant as it is in addition to other funding through the core contract, and CCGs will not be allowed to siphon it off into other parts of the NHS.”

Baker added, “We are encouraged by the confirmation that proposals for extended hours will not be a ‘three line whip’ for all GPs but be determined by local need, with the promise of appropriate funding.”


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