MPs have informed NHS officials that they must define what services practices are required to deliver during core hours by March of next year.
The House of Commons Public Accounts Committee indicated that NHS England must report back within 12 months regarding the definition of what patients should expect to be available between the conditioned hours of 8 am and 6:30 pm.
Officials will also be required to explain how they will ensure commissioners contract-manage practices effectively in order to meet the requirements.
As part of the existing GMS contract, surgeries are not required to be open throughout core hours, but must deliver essential services in order to meet reasonable needs of patients.
Yet despite this broad guideline, the Public Accounts Committee has criticised the existing terms for failing to define “what patients should reasonably expect from their practice during core hours. To date local commissioners have not had a consistent view on how to define the reasonable needs of patients, particularly as this has never been written down and agreed.”
NHS England will be collaborating with the British Medical Association in order to ensure that reasonable needs, such as appointment bookings or prescription collections, are written down and operated appropriately.
NHS England Director of Commissioning Rosamond Roughton had already defined what she considered to be reasonable terms before the committee in March.
“I think that definition means you should be able to phone your practice and book an appointment, pick up a prescription, drop off a specimen. If results come into the practice that require urgent attention there should be someone there to pick that up – if it’s to do with your warfarin monitoring for example, there should be someone there to contact the patient. I think we need to write that down.”
MPs have previously stated that the Department of Health and NHS England have been guilty of rolling out extended hours throughout the healthcare system “without really understanding the level of access currently being provided or how to get the best from existing resources”.
There are also concerns about finances, with some estimates indicating that the new extended access services could cost 50% more than core hours services, but also duplicate existing provision.
Commenting on the issue, GPC chair Dr Chaand Nagpaul stated that this once again indicated the climate of pressure in general practice currently.
“This is yet another important report that highlights that general practice is under incredible strain with many GP practices struggling to cope with rising patient demand in a climate of stagnating budgets and staff shortages.”
Nagpaul particularly pointed to workforce figures that underline the declining level of staffing in the healthcare system.
“The latest workforce figures showed that last year there was a decline in the number of full-time GPs working in the NHS. The promised recruitment of 5,000 extra GPs remains a pipe dream that shows little sign of materialising in the next few years. Precious resources are being diverted to offer routine weekend appointments in some parts of the country when at the same time many GP services are struggling to provide effective, safe care to their patients during weekday opening hours and in urgent care settings in evenings and weekends.”
RCGP chair Professor Helen Stokes-Lampard concurred that there are massive pressures on general practice and the Royal College “agrees with the report that forcing GPs to work 8am to 8pm, seven days a week, regardless of patient demand makes little sense and is not cost-effective.”