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Early closing of your GP practice may not be an option this Christmas and New Year

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It seems to happen at this time every year. NHS England threatens GP practices with breach notices if they dare to close early on a single day over the Christmas period. If previous years are anything to go by, you can expect staff from NHS England to check that your practice is open. In 2014, for example, 12 GP practices in London were hit with breach notices for being closed at 15:30 on Christmas Eve 2013. One practice was later threatened with closure for closing early on both Christmas Eve and New Year's Eve.

As ever, the General Practitioners Committee (GPC) is at loggerheads with NHS England. Dr Robert Morley, the contracts and regulations lead at the GPC, argues that early closing is "perfectly legitimate under the regulations if it is going to be clear that demand for appointments will be low and practices are still meeting the reasonable needs of their patients."

What the regulations say

On the face of it, Dr Morley is absolutely correct in what he says. Official guidance states that your practice can close early on bank holidays if you have prior written permission to do so. This permission should be agreed between the provider and the CCG commissioner.

Traditionally, practices have closed early on the working day before Christmas and New Year. This year, the last working days are the Fridays before Christmas Eve and New Year's Eve.

Current 'guidance' is more cautious about closing

Once again, NHS England is taking the cautious approach to early closing. It says that "GP out-of-hours providers have previously expressed concern about early closing of general practices at Christmas and New Year and the potential impact on them.

"Given the pressures that out-of-hours providers already face during this period, this may not be a reasonable or sustainable service option."

A clear indication that it doesn't want practices closing early – although it also says that the final decision should be made by regional teams of CCGs.

What you should do

If your practice wishes to close early, then you'll need to notify your commissioner of your proposal to sub-contract to an out-of-hours provider. When making its decision whether to agree to the early closing proposal, the commissioner will need to be certain that the out-of-hours provider will be able to deliver the essential services required during the hours of closure.

Without this agreement, you'll need to keep your doors open on Friday 23rd and Friday 30th of December right through to 18:30 as per the contract.

Are you likely to get agreement to close early?

Dr Morley says that consent by your commissioner "must not be reasonably withheld."

The inference is that if your application to close is both reasonable and your out-of-hours provider is able to provide the cover required, there should be no reason for your application to be turned down.

He also said, "It is highly unlikely that such early closing will then lead to any increase demand during the out-of-hours periods. Practices might choose to deal with this by having a practice duty doctor on call or reciprocal arrangements with another named GP."

Heed the GPC advice

If your practice is planning to close early over the Christmas and New Year period, the GPC advises that you:

  • Make patients aware of closure in advance, notifying on surgery notice boards, your website, and repeat prescriptions
  • Put in place procedures to ensure that repeat prescriptions are ordered and collected in time and before the period of closure
  • Change answerphone messages at 18:30 on the day of early closure where there is a change of provider to NHS 111

Will you be closing early and transferring services to an out-of-hours provider, keeping normal hours with a full staff? Or covering with a practice duty doctor, locum, or another named GP?

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