GP practices are being told to stop closing at lunch or potentially face having their purses tightened.
Battle lines are being drawn in Kent and Medway, with health officials going to war with family doctors to improve patient accessibility.
The area’s Integrated Care Board — which controls regional NHS budgets — issued a notice last week to remind surgeries that ‘closing at lunchtime is not permitted’.
Officials promised to issue offending practices ‘remedial breach notices’, if they are proven to have defied the rules or needs of patients.
Although unlikely, it could see funding being withheld from surgeries, most of which are ran as private businesses and contracted by the NHS.
The NHS is threatening GP practices who close during lunch with a breach notice of their contact with the health service (stock image)
Seeing your doctor should not be like booking an Uber driver, MPs say
Seeing your GP should not be like booking an Uber driver who you will never see again, MPs say, as they call for a cap on surgeries’ patient list lengths.
In a major 65-page report on the future of GPs, the Health and Social Care committee has said that GP-patient relationships should be from the ‘cradle to grave’.
MPs want the Government and NHS England to abolish ‘micromanagement’ frameworks measuring too many targets ‘which risk turning patients into numbers’.
They should instead focus on looking at limiting the number of patients on a GP’s list to 2,500, for example, which would slowly reduce to a figure of around 1,850 over five years as more GPs are recruited as planned, it said.
Under the NHS England contract, practices are supposed to be open between 8am and 6.30pm on non-bank holiday weekdays.
There is still some flexibility, however, as surgeries are allowed to close for part of the day, for example for lunch or staff training.
But this is only if signed off by local health bosses.
Surgeries must also ensure they are still meeting the needs of their patients, such as by directing patients elsewhere.
The notice issued to Kent and Medway GPs, seen by Pulse, said that there had ‘been recent media coverage of practices closing at lunchtime and it will continue to be a subject of interest’.
It stated it ‘may be necessary for the ICB to issue the practice with a remedial breach notice’ if there wasn’t any evidence the closures had been approved.
‘As you are aware, closing at lunchtime is not permitted,’ it added.
‘While Kent and Medway ICB fully appreciates that practices are faced with staffing pressures, doors are required to remain open to patients between 8am to 6.30pm, Monday to Friday.
‘If it is identified that a practice is closing without commissioning approval then it may be necessary for the ICB to issue the practice with a remedial breach notice, if the practice is unable to provide evidence of commissioning approval and that the closure meets the reasonable access needs of their patient population.’
The Kent Local Medical Committee, which represents GP practices across the area, is challenging the ICB over the contractual basis of the alleged breaches.
British Medical Association guidance says the NHS contract does not explicitly say practices must be practices must be open at all times during core hours.
England’s GP postcode lottery: Official data shows some areas have half as many doctors per patient as others. Nuffield Trust analysis shows there are 39.5 GPs caring for every 100,000 people in Portsmouth. People in Thurrock have 40.3 family doctors for every 100,000 people in the area and in Hull there are 41.9 per 100,000
Official figures show GPs’ average pay spiked during the pandemic shooting up about £10,000 to almost £112,000 in the latest reporting period
In March this year, Kent and Medway CCG, the predecessor to the ICB, reported that almost 17 per cent of the area’s 192 GP practices closed at lunch as of April 2021.
No more up-to-date figures we have been released since then.
A spokesperson for the ICB said: ‘We are aware a small number of practices have been closing their doors at lunchtime.
‘We have made very clear to them that patients should be able to access GP services between 8am and 6.30pm, their core contractual hours.
‘We understand the enormous pressure general practice is under and we are happy to work with practices on how best to meet local patient demand.’
Kent and Medway has one of the worst GP shortages in England, with only about 45 family doctors per 100,000 people, according to NHS data.
GP access has become of the hottest battle grounds between the Government and health leaders.
Two-thirds of appointments with family doctors in England last month were in-person, according to the latest data from NHS Digital. The 66.1 per cent figure is still well below the 80 per cent average before the pandemic struck. However, it is the highest rate since March 2020, when the UK was plunged into its first national lockdown as the coronavirus swept across the country
There were just 27,558 full-time equivalent, fully-qualified GPs working in England last month, down 1.6 per cent on the 18,000 recorded in June 2021. It was down 5.3 per cent on the more than 29,000 working in June 2017
Ministers have promised to fix the ‘telephone lottery’ to talk to a GP in the morning and boost the number of face-to-face appointments, which are still lagging behind pre-pandemic rates.
Just two-thirds of appointments with family doctors in England last month were in-person, according to the latest data from NHS Digital.
The 66.1 per cent figure is well below the 80 per cent average before the pandemic struck.