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A GP must be physically present at all times during PCN enhanced access hours

by Costanza Potter
4 May 2022

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 A GP must be physically present at all times during PCN weekday evening and Saturday enhanced access appointments, NHS England has confirmed.

Earlier this month, the BMA GP Committee advised that a GP must be ‘available’, but not necessarily ‘physically’ present during enhanced access shifts offered by PCNs under the new DES.

This was based on ambiguity in the wording of the contract document.

However, NHS England has now said that a GP is required to be physically present at all times.

An NHS England spokesperson told Management in Practice’s sister title Pulse: ‘From October, all primary care networks will be required to ensure a GP is available to see patients face-to-face on Saturdays between 9am and 5pm, as is already the case in many parts of the country.’

They confirmed on background that this means a GP must be physically present at one GP practice within a PCN area throughout the whole enhanced access service period – 9am-5pm on Saturdays and 6.30pm-8pm on weekdays.

The network DES said that enhanced access services should be ‘delivered by a multi-disciplinary team of healthcare professionals employed or engaged by the PCN’s core network practices, including GPs, nurses and additional roles [staff] and other persons employed or engaged by the PCN to assist the healthcare professional in the provision of health services’.

However, it added: ‘A PCN must ensure GP cover during the Network Standard Hours providing in-person face-to-face consultations, remote consultations, leadership, clinical oversight and supervision of the MDT.’

It comes as Pulse revealed last week that PCNs will need to provide GP appointments covering the ‘full’ periods of 9-5 on Saturdays and 6.30pm-8pm on weekdays.

It was previously unclear whether PCNs were required to provide appointments throughout the whole period rather than just within the stated hours.

The BMA last week said that NHS England has rejected its requests for certain relaxations of the DES, including around Saturday opening times and GP availability for the new extended hours service.

It has repeatedly encouraged practices to consider their ongoing participation in PCNs.

Practices have until 30 April to opt out of the DES without breaching their contract as part of the current annual opt-out window, but may have additional 30-day windows to do so if any in-year changes are made to the enhanced service specification.

Meanwhile, GPs attending the annual conference of UK local medical committees (LMCs) next month will vote on policy to reduce core GP hours to 9am until 5pm.

What is the PCN enhanced access service?

The DES set out the requirements for PCNs to provide enhanced service access from 6:30pm to 8pm on weekdays and 9am to 5pm on Saturdays.

Under the requirements, networks will have to provide 60 minutes’ worth of appointments per 1,000 population within the network, and these will have to be delivered within the hours stipulated – but they won’t have to cover the whole periods.

The appointments will be available ‘for any general practice services and services pursuant to the Network Contract DES that are provided to patients, the DES says. It also says that they should be bookable a minimum of two weeks in advance, and that same day appointments should be made available.

The service will go live in October, when it will be funded £7.46 per patient pro rata. Until then, networks will receive 72p per patient for the preparatory arrangements.

PCNs must submit plans to commissioners by 31 July, which will set out the mix of services to be provided, how networks will offer appropriate levels of face-to-face appointments and what locations are to be used.

This story was initially published on our sister title Pulse.

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