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Practices will not have guaranteed funding for extended hours access

by Léa Legraien
4 February 2019

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There is no guarantee GP practices will continue to receive funding for the provision of the extended hours access directed enhanced service (DES), under the new GP contract.
 
From July, the extended hours access DES will be transferred from practices to the new primary care networks.
 
The change, which forms part of a the five-year GP contract, means NHS England will no longer directly pay practices to deliver the service, although the BMA said the money should flow from the networks into the practices.
 
Under existing extended hours DES, practices are paid to ‘offer patient consultations face to face, by telephone or by other means at times other than during the core hours’ as stated in the contract.
 
But NHS England said it intends to move the service’s requirements and funding to networks in a bid to better join up the urgent care system.
 
BMA GP Committee chair Dr Richard Vautrey told our sister publication Pulse practices ‘will not get the money directly’, and explained it will be allocated to the networks, which will then decide how to disperse the money between the practices.
 
Although Dr Vautrey could not confirm whether practices will be guaranteed to receive the funding, he said it ’should flow back to practices through the networks’.
 
NHS England said rather than ‘removing’ the current pot of funding for the extended hours access service, which totals £87m, it will ‘transfer’ the money to networks from July 2019.
 
This will come on top of a recurrent £30m, which will be added to the global sum in 2019/20 to ‘reflect the increased population coverage of the extended hours access requirements’ and fund the new 111 direct booking service.
 
The contract said: ‘Transition will begin on 1 July 2019.
 
‘Instead of allowing the extended hours access DES to draw to a close, removing £87m a year from general practice contract funding, we have agreed to transfer the extended hours access DES requirements and existing funding to the network contract DES from July 2019 until it becomes part of the funding for the combined access offer in April 2021.’
 
The primary care networks – which will cover 30,000 to 50,000 patients and be led by a local GP in a clinical director role – were announced earlier this month, with practices being mandated to join them in return for a £4.5bn funding boost.
 
According to NHS England, an average network with a population of 50,000 will be required to provide 25 hours extended access per week, which will be shared between morning, evening and weekends.
 
’All extended hours slots would, as now, need to be delivered by the constituent practices of the network’, it added.
 
Dr Vautrey said further documents detailing the structure of primary care networks and how they will work will be released in the next couple of weeks.
 
NHS England previously told CCGs to ensure the new primary care networks are in place by 30 June at the latest.
 
This story was first published on our sister publication Pulse.