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Government handling of extra hours unacceptable, say 98% of GPs

The government's method of negotiation over contract changes regarding extended hours is "not acceptable", say 98% of the 27,469 UK GPs polled by the British Medical Association (BMA).

In addition, 82% said they were "not at all confident" in the government's handling of the NHS.

The poll was conducted in response to the government giving the BMA's GP Committee (GPC) the choice of two options over extended hours.

A huge majority - 96% - said they were opposed to both options but the one they had chosen was "the less worse of the two".

More than nine in 10 GPs selected Option A - in which money is made directly available to surgeries to fund extended hours through a reallocation of directed enhanced services (DES) - rather than Option B, in which funding would be allocated to primary care trusts (PCTs) to agree local contracts for extended opening.

Commenting on the poll results, GPC Chairman Dr Laurence Buckman said: "The government must take heed of the strength of feeling shown in this poll.

"It cannot be good to have such a key part of the health workforce feeling disengaged from the way the government is handling the health service. The effect can only be corrosive and in the long term it is not a good way to get the best service for patients.

 "If there is a clear message to come out of this it is that we cannot continue in this way. We want patients to be happy with the service they get from GPs, but it will only work if GPs feel they can trust the government not to bully and micromanage them all the time."

The new extended access DES will require practices in England to deliver 30 minutes of consultation time per week outside core hours. So a practice with 6,000 patients would deliver an extra three hours a week of consultation time.

However, nurse appointments will not be recognised under this DES. According to the GPC, these requirements are unlikely to allow two GPs to provide extended hours consultations at the same time, other than in circumstances agreed by the PCT.

Dr Buckman said: "It is the particular inflexibility of the government's offer that makes GPs find this difficult to work with", adding that the proposals do not recognise the skill mix of modern general practice.

Dr Richard Vautrey, GPC Deputy Chairman, said that as the proposals allow only for GP appointments, patients told they will be offered extended hours will be disappointed to discover this does not include treatment by nurses or other practice team members.

He also highlighted safety concerns of GPs working alone in the practice later in the evenings.

Dr Buckman insisted the objections were not about working longer, but "a range of issues in general practice" that could affect the quality of patient services.

"Let me emphasise that a majority of GPs were and remain willing to provide extended hours surgeries," he said. "However, GPs believe they are being railroaded into an unrealistic vision of extended hours."

Dr Vautrey added that the issue was "much, much wider than extended hours. The real issue is the direction that general practice is going".

In the GPC poll, 92% of GPs say they believe the government's policy of bringing private providers into NHS general practice will be bad for patients and the service as a whole.

"However," Dr Buckman concluded, "it is time to draw a line under this and the BMA will now work towards the practical implementation of this package."


Related news feature: Nurses' anger over extended hours

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