MEDI-MAIL . . . Out Of Hours (OOH)

Out Of Hours Service (OOH) – The NHS and the GMS contract

A major study on out-of-hours care has highlighted the huge workload and costs that GPs carried prior to the introduction of the opt-out clause in the contract.

Under the terms of the new GP contract, all GPs had the ability to opt out of the provision of Out of Hours services. Where this occurs the responsibility would pass to the Local Health Board.

At the LMC conference, GP leaders were looking at how the profession could take back a degree of responsibility for out-of-hours care.

LMCs backed a motion calling on the GPC to consider moves for GPs to take on responsibility for commissioning out-of-hours services.

Dr Michael Dixon, chair of the NHS Alliance and an adviser to Lord Darzi, described the vote as a ‘landmark’. He said pilots could be set up in volunteer practice-based commissioning ‘hotspots’ to gauge GPs’ readiness to take on commissioning responsibility more widely.

But questions remain over how a transition could work in practice, with the vast majority of GPs strongly opposed to taking back any personal responsibility for out-of-hours care.

GPC leaders said any move would depend on the success of PBC, which is only up and running in England.

GPs could take Out Of Hours back by:

Government advisers suggest pilots could be set up in volunteer PBC ‘hotspots’ to gauge GPs readiness to take on commissioning responsibility more widely.

Problems over how changes could be implemented outside England must also be addressed – with PBC currently in England only.

PBC clusters could take control of out-of-hours commissioning.

Another barrier is existing deals with private companies across the country, some signed only in the last few weeks.

Meanwhile…

2 PCT Trusts, namely Herefordshire, Buckinghamshire, have abandoned proposals for GP-led health centres as a poor use of money, in a direct challenge to Lord Darzi’s plans for every PCT to have at least one.

Herefordshire PCT has scrapped plans to tender for a standalone GP-led health centre after local needs analysis revealed it would cost an estimated £1.1m in staff expenses alone. ‘It was therefore considered this service model was neither affordable nor represented value for money,’ the trust said.

Buckinghamshire PCT admitting ‘on reflection the PCT decided further work was necessary to assess the most cost-effective and operationally sound model’ and has put aside all applications.

Medi-Mail News

Key words: GMS, Lord Darzi, NHS, OOH, PBC, PCT