GPs prepare to take back OOH under Tories

By Nigel Praities

GPC leaders have begun planning how a new GP-led model for out-of-hours services would work under the Conservatives, as they prepare for a major shake up of the sector as one of the first health priorities of a David Cameron Government.

Delegates at the LMCs conference in London heard the committee was already drawing up details on proposed safeguards, to make sure GP practices were not swamped with extra work if they were handed responsibility for commissioning services.

The move represents a significant shift from the GP leadership and came as for the second year in a row the conference passed a motion calling on the GPC to pave the way for GPs to take back responsibility for out-of-hours cover.

Despite admitting huge concerns over such a move, this time the GPC revealed it had already begun putting together proposals it hopes would be incorporated should the Conservatives make changes to the GP contract.

Dr Nigel Watson, GPC member and chief executive of Wessex LMCs, told the conference: ‘Work has already begun. We have asked the commissioning sub-committee to look at it. This was one of the motions you put to us last year. We believe GPs should only be involved with PCOs and not take back commissioning of OOH,’ he said.

The subcommittee, he said, had started to compile a list of minimum standards to underpin the move and ensure GPs were not saddled with an unrealistic workload.

A motion was later passed calling for specific criteria to be drawn up to facilitate the change in responsibility.

It read: ‘The conference demands, in respect to OOH care, that the GPC agree and publish a minimum set of criteria that should apply in the event the profession takes back responsibility for commissioning of OOH care.’

The motion also called for PCOs to allocate ‘reasonable funding levels’ to out-of-hours providers, to ensure they could provide good quality care.

Proposing the motion, Dr Richard Withers, a GP in Peterborough, said the standard of out-of-hours care commissioned by PCTs was so low in some areas that minimum standards were needed before GPs could take back responsibility.

‘These minimum criteria should express the level of quality and enable GPs to make decisions over how OOH is delivered.

The GPC should agree and publish criteria before the next election. They have to engage with this area and make it a priority,’ he said.

But some GP spoke against the move. Dr Hal Maxwell, a GP in Ballantrae, in Ayrshire and Arran, said: ‘I actually believe this will be a mistake. This service is broken. It is not meeting patient’s needs. Why should we be made responsible?’

Road to GPs taking back OOH care

-

Oct 2007: Conservatives say they would put GPs in charge of commissioning out-of-hours cover for their patients

June 2008: LMC conference votes to ‘consider’ taking back OOH care if it is funded adequately

Sept 2008: Healthcare Commission finds a third of OOH providers are not meeting key national requirements

May 2009: Care Quality Commission launches inquiry after a patient dies after receiving care from a foreign locum

Jun 2009: LMC’s conference instructs the GPC to come up with a detailed plan for how OOH’s will work with GP in charge