NHS England officials have given indication of the way that core hours will operate in the forthcoming GP contract.
And the authorities have also stated that there will be no so-called ‘big bang’ contract reform in the 2018/19 financial year.
Nonetheless, the forthcoming contract will see the requirements for core hours tightened significantly.
NHS England Director of Primary Care Ros Roughton told MPs at a House of Commons Public Accounts Committee hearing that guidance will be explicitly documented regarding core hours opening roles in the coming months.
Officials told MPs that the NHS intends to diverge from the traditional ‘high trust’ system, which is reliant on GP practices making independent decisions regarding the interpretation of contractual requirements for core hours.
Currently, GP practices are not required to be open throughout core opening hours of 8am to 6:30pm, but essential services to meet the reasonable needs of patients must be on offer.
Roughton provided her personal definition of the reasonable needs of patients at the Public Accounts Committee hearing
“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.”
The Director of Primary Care also spoke on the issue of communication between NHS England and the British Medical Association, noting that part of the contract deal would be open communication and collaboration between the two on LMC core hours opening.
Roughton asserted that writing down roles would provide more certainty to organisations within the healthcare system.
NHS England chief executive Simon Stevens suggested that there are significant regional variations that must be understood if the core hours system is to operate appropriately.
“About 75% of the half-day closures are concentrated in about a quarter of CCGs. So there is geographical targeting we need to do in practices in those areas,’ he said. ‘We are now following up with practices in those geographies. From October the GP contract is going to change and practices will no longer be eligible for that enhanced service payment if they have on a weekly basis half-day closure.”
But it is already known that 15% of practices in England face longer opening hours in order to avoid losing £8,000 on average of extended hours funding, as part of the newly agreed 2017/18 contract deal.
According to a National Audit Office report report, 18% of GP practices in England close at or before 3pm on at least one weekday.