The BMA will ‘challenge’ a contract requirement for GP practices to keep their online systems switched on until 6.30pm regardless of capacity, according to its GP Committee chair.
Dr Katie Bramall-Stainer was responding to concerns around practices in England being denied PCN funding if they turn off their online triage systems when their practices are full.
According to PCN DES documents, from this year online consultation needs to be available for patients to make administrative and clinical requests ‘at least during core hours’ in order for practices to receive full funding from the Local Capacity and Access Improvement Payments (CAIP).
Dr Bramall-Stainer said that leaving online tools on until 6.30pm ‘irrespective of demand or capacity’ was ‘not raised’ during contract discussions earlier this year and said the GPC would ‘challenge’ the requirement.
In its letter to practices about the GP contract changes, NHS England said that each PCN clinical director ‘will need to provide assurance’ to their ICB that these requirements are met. It added these conditions ‘can be met at any point’ during the year and PCNs will receive payment in-year once they are met.
Dr Bramall-Stainer said the BMA is producing a guidance documents on these requirements, which will be published ‘very soon’.
Writing on X, she said: ‘Leaving online tools on until 18:30 irrespective of demand or capacity was not raised during discussions. We are challenging this.
‘Note, I might not decide to sign this until for example 28 March 2025. By which time we shall have a new Government. And you’ll still get your funding.
‘I appreciate that those practices facing major cashflow issues won’t have that luxury. If that were me, I would tick the “yes of course I’m triaging” box, but I might take a stand over the online access 10%.’
Last year, practices in one area were advised to switch off their online consultation systems ‘at a minimum’ outside core hours and consider disabling them during core hours as a response to ‘unmanageable and unsafe workload’.
And Pulse reported on LMCs warning that online access was overwhelming GP practices which did not have the capacity to cope.
Also on X, Dr Bramall-Stainer went on to suggest GPs delay signing the cloud based telephony (CBT) data provision notice (DPN) if their cash flow ‘could afford it’.
This year’s GP contract was amended to require practices to provide digital telephony data on eight metrics through a national data extraction, for use by NHS England, ICBs and PCNs, but the commissioner claimed this will not be used to track practices’ performance.
The GPC has asked NHS England to immediately pause its cloud-based telephony project, following concerns around ‘skyrocketing’ costs for GP practices.
An NHS spokesperson said: ‘While we understand practices need time and support to move to Modern General Practice and effectively make changes, practices should be offering patients parity of access regardless of how they contact a practice, whether that is online, by phone or walk in, during core hours, so everyone is treated fairly.’
I think before any decision can be made on whether online triage systems should be on or off at any time (including OOH times), it would be essential to understand what the systems did with requests that were triaged by it : does it indicate that an administrative request will be dealt with within so many working days, and does it triage a late clinical request to the OOH service or into a black hole until monday morning???
Online access has been forced upon us in time for the general election to enable the government to proclaim that they have ended the “8am rush”. No other profession has to put up with this nonsense.