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Staffing Covid hot hubs falls under GMS contract, says NHS England

by Costanza Pearce
15 May 2020

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GP practices are contractually required to staff Covid-19 ‘hot hubs’ and should do so with existing resources ‘in the first instance’, NHS England has said.

NHS England director for primary care strategy and contracts Ed Waller was responding to a GP question in a live webinar last Thursday when he provided the clarification.

This follows Management in Practice’s sister publication, Pulse, reporting on one LMC which has taken issue with their local CCGs demanding hot hubs be commissioned separately from core contractual work.

In Thursday’s webinar, an anonymous GP asked NHS England for guidance after their CCG had ‘deemed hot sites as GMS so expect practices to provide the staff without any additional resource’.

To which Mr Waller responded: ‘Meeting the Covid-19 needs of your patient list is as much a part of GMS as any other type of illness and so we’d expect in the first instance that resources from practices would be redeployed into any new services that are set up.’

The redeployment of both clinical and managerial staff into ‘new arrangements’ is expected as part of the ‘quid pro quo of guaranteeing income into practices’, he added.

Practices can be reimbursed for extra staff required due to the pandemic from the Covid support fund, Mr Waller said, but only in relation to ‘additional capacity’ needed ‘above and beyond’ current net capacity.

Kent LMC medical secretary Dr John Allingham told Pulse that existing GMS funding is not enough to cover the running of hot hubs.

He said: ‘As we return to normal activity, running Covid hot hubs and running normal general practice activity is not reasonable out of the existing GMS envelope.’

He added that a ‘lag’ with secondary care is currently putting ‘additional workload and stress on the system’, as rejected referrals leave practices ‘struggling to hold the risk’.

Meanwhile, even if in some cases clinical staff have some capacity, practices lack the resources to redeploy non-clinical staff to hot sites, he added.

He said: ‘Having to run two sites means doubling receptionists and admin teams, that’s not GMS. That’s overtime and needs to be funded separately out of Covid money.’

And promises of additional funding inspire little confidence because they rest on NHS England’s ‘definition of net capacity, not ours’, he added.

Berkshire, Buckinghamshire and Oxfordshire LMCs previously wrote to local CCGs to say that face-to-face hot hubs work was non-contractual and therefore GPs should be able to refuse to staff them – especially if they are at raised risk from coronavirus.

LMC co-chief executive Dr Richard Wood said: ‘This is a question about whether hot hub services should be delegated down to practice level. 

‘What we should be asking is: Is this safe for our vulnerable patients? Is this safe for GPs and their staff? Is this feasible?

‘If the answer to any of these questions is ‘no’, we think hot hubs should have their dedicated commissioned service.’

It comes as GPs in Northern Ireland have been told by their Government that they will face contractual changes if they refuse to staff hot hubs.