Navigating compliance: GP core hours

In the everyday hustle of running a GP practice, sticking to the rules can be a bit of a juggling act. One crucial aspect is making sure you’re on the right side of the core hours game, which runs from 8:00 am to 6:30 pm, Monday to Friday. Let’s break down the challenges to ensure your practice stays compliant

CREDIT: This is an edited version of an article that originally appeared on Londonwide LMCs

Practices are getting called out for two things. First, some are caught closing their front doors during core hours, usually when the team is catching up on admin, training, or using protected learning time. Even though, most times, there’s another access system in place. The second hiccup is when practices switch their phone lines to someone else or use a bypass number, which often happens in the morning, during lunch, or towards the end of the day.

Commissioners are keeping an eye on practices through electronic submissions, website checks, talking directly to practices, patient grumbles, or feedback from other health services like the London Ambulance Service. If someone struggles to get through on the bypass number, it usually ends up on the commissioner’s radar.

Breaking down the contract talk

GMS and PMS agreements stress the obligation to meet reasonable patient needs during these hours. While the British Medical Association (BMA) clarifies that practices need not be open at all times, meeting patients’ needs is non-negotiable. Practices must ensure accessible services during core hours, even if temporarily closed for training or reviews.

Commissioner expectations

London commissioners advocate for open doors and active telephone lines throughout core hours, treating any deviation as a deviation that warrants justification. Practices with alternative access systems must prove their efficacy, such as commissioner-approved subcontracting or bypass numbers ensuring continuous patient access during emergencies.

The BMA’s advice aligns with this – it’s all about making sure patients get what they need when they need it. The trick is to explain it right; a closed sign during staff training doesn’t mean the whole place is shut. Online services stay up and running during core hours.

Watch your words

Saying “closed” when you’re just doing admin or training might confuse patients. Practices need to get the message across clearly on their electronic submissions and all their online and physical platforms.

Self-checklist for practices

Making sure you’re ticking all the boxes can be a bit like a dance routine. Practices should adhere to a checklist for core hours access arrangements:

1. Consistent communication: Align information on opening hours across all platforms.
2. Accurate e-DEC submission: Clearly state alternative access arrangements in e-DEC submissions.
3. Visible signage: Inform patients of alternative access during core hours through signage, telephone messages, and online.
4. Emergency access: Implement doorbell or intercom access during alternative processes for urgent patient issues.
5. Telephone clarity: Clearly communicate telephone line status during rerouting, ensuring patient awareness and testing regularly.
6. Bypass phone checks: Regularly test and monitor bypass phone lines for functionality and staffing adequacy.
7. Staff awareness: Ensure staff are informed and convey consistent messages to patients.
8. Patient engagement: Solicit feedback from Patient Participation Groups (PPG) on alternative access arrangements.

Should commissioners question practice hours, practitioners must furnish evidence demonstrating service alignment with patient needs, emergency provisions, and patient engagement through PPGs.

Practice managers must ensure their practice’s alternative access systems are robust, well-documented, tested, endorsed by the PPG, consistently publicised, adhered to, and duly reported to the ICB. With this approach, practices can confidently navigate the complexities of core hours, meeting patient needs while staying in step with regulatory requirements.