Paper Summary Sheet Presented to: Primary Care Commissioning Committee Date of Meeting: 26 June 2018 For: Decision Agenda Reference: Title: PCCC/18/06/07i Extended and Core Hours Executive summary: The General Medical Services (GMS) and Personal Medical Services (PMS) Regulations require general practice contractors to provide essential and additional services at such times within core hours,.(that) are appropriate to meet the reasonable needs of patients, and require the contractor to have in place arrangements for its patients to access those services throughout core hours in case of emergency. Core hours for GMS practices are 8:00 18:30, Monday Friday, excluding weekends and bank holidays. Opening hours for PMS and APMS practices are set out in their contract but largely mirror GMS opening hours or longer. Guidance has been drafted to help commissioners to work with their providers of general practice in respect of the services that they offer to patients during core hours as well as the conditions that should govern the commissioning of extended hours. The wording of the GMS contract permits practices to subcontract their services during core hours with the approval of the commissioner. As there is no limitation within the contract to the number of hours that can be subcontracted, commissioner approval is central in determining what is acceptable or unacceptable. The attached paper attempts to demonstrate as a responsible Commissioner what is acceptable; and the extent of the issue in Wiltshire CCG. Nationally practice closures according to the practice electronic declaration (as at December 16/17) indicated that 53% of practices reported their reception to be closed for 30 minutes, on at least one day a week and 25% of practices closed for 30 minutes every day during the week. This could be a short closure for lunch, opening at 08:30 instead of 08:00, or perhaps closing at 18:00 instead of 18:30. At the other end of the spectrum one in seven GP practices close for a half day every week. In Wiltshire the headlines are slightly better; with 30% of practices reporting their reception desk to open later than 08:00, 18% reporting their reception desk to close earlier than 18:30, 20% reporting their reception desk closes for lunch and 12% close for half a day within the week. Only one practice has reported it routinely closes for one hour every month for an in-hours short period closure for a practice meeting. Interestingly one practice has also reported it closes its reception desk routinely at 17:00 three times a week and another who has reported it closes its reception desk routinely at 16:00 every Monday, 15:00 every Wednesday and 17:00 every Friday.
A review of half-day closures in Wiltshire has found the following: Name of Current List Contract Details of the arrangement Size Type Old School House 3721 PMS The practice has informed the CCG via email and reported via electronic declaration they close every Thursday afternoon. Assurance received the practice complies with reasonable access but no details of the sub-contracted arrangements are held Burbage Surgery 3754 PMS The practice has formally informed the CCG and via electronic declaration they close every Wednesday afternoon. Assurance received the practice complies with reasonable access but no details of the sub-contracted arrangements are held Orchard Partnership (Spring Orchard, Fovant Surgery) 11113 (across Partnership) GMS The Spring Orchard practice has informed the CCG via email, but not via electronic declaration they close on a Wednesday afternoon. The phones transfer to Hindon, GP can see face to face, or home visit. They have access to TPP notes. However, the practice has three other sites available, of which registered patients have full access to services available if they wish to Hindon Surgery 2403 GMS The practice has informed the CCG via email and has reported via electronic declaration to close every Tuesday afternoon. Phones transfer to Orchard, GP can see face to face, or home visit. They have access to TPP notes. Also aware from electronic declaration analysis the practice reports to close at 5pm and phones divert to duty doctor which is the Senior Partner via his mobile. He has confirmed full access to notes Silton 1896 PMS The practice has formally informed the CCG and reported via electronic declaration they close at 3pm every Wednesday. No sub-contracting arrangement is in place. Jubilee Field 4559 PMS The practice has formally informed the CCG and reported via electronic
declaration they close every Thursday afternoon. No details held of the subcontract arrangements as yet. Sixpenny Handley 4244 PMS The practice has now informed the CCG of the closure and reported via electronic declaration they close every Tuesday afternoon. The practice also has a branch surgery that is open on a Tuesday afternoon and patients have full access available in this period. It should be noted all practices currently provide extended access. A similar review of all short term closures including late opening i.e. reception opening at 08.30, lunchtime closures and early closing i.e. reception closing at 18.00 has found 30% of practices reporting their reception desk to open later than 08:00, 18% reporting their reception desk to close earlier than 18:30, 20% reporting their reception desk closes for lunch. Below is a summary of these practices including their contract type and number of hours lost to the NHS each week based on the core GMS criteria. Name of Current List Size Contract Type Closure Type Patford 8844 GMS Reception opens 08.30 every day House Reception closes 18.00 every day Burbage 3754 PMS Reception opens 08.30 every day Reception closes for lunch 13.00-14.00 Mere 4615 GMS Reception opens 08.30 every day closes every Tuesday, Thursday and Friday at 17.00 Jubilee 4559 PMS Reception opens at 08.30 every day Field Reception closes for lunch 13.00-14.00 closes every Tuesday and Friday 18.00 Silton 1896 PMS Reception opens 08.30 every day will continue half day closure every Wednesday closes Monday 16.00, Wednesday 15.00 and Friday 17.00 Whiteparish 6699 GMS Reception opens 08.15 every day Reception closes for lunch 13.00-14.15 Hours Lost per week 5 As Commissioner we will need to be assured that there is no duplication of payments for example provision of seven day access. All sub-contracted arrangements must be resourced by the practice(s) wishing to sub-contract essential services during core hours. 7.5 10 8.5 10 7.5
The Committee is asked to approve:- Recommendations: Previously considered by: Author(s): Sponsoring Director / Clinical Lead/ Lay Member: 1. All contractors who wish to sub-contract core service in hours either need to seek approval or inform the CCG as contractually appropriate 2. All contractors without sub-contractual agreements/no sub-contractual agreements that do not meet the key guidance criteria as listed will not be approved for extended hours payments 3. To approve the continued interrogation into the impact of short term closures on general practice and the wider health economy. Primary Care Operational Group Victoria Stanley, Primary Care Commissioning Manager Jo Cullen/Dr. Andrew Girdher/Christine Reid Risk and Assurance: Financial / Resource Implications: Legal, Policy and Regulatory Requirements: Communications and Engagement: Equality & Diversity Assessment: Adherence to policy will continue to be monitored through various surveillance routes and assurance will continue to be sought through the key lines of enquiry with any future approvals to be presented to the Committee. None identified at present. Further investigation on the short-term closures across the County may pose a question for the Committee to decide upon contractual action. This may impact on the resilience and future sustainability of General should the Committee insist on a higher level of capacity be insisted upon from General. At this time, this is un-founded and further work will need to be untaken to prove this theory. NHS England, Primary Medical Care Policy and Guidance, 2015. NHS England, GP Access; Expectations in respect of Extended and Core Hours, National Standards and Guidance for Commissioners Policy, 2017 Continued engagement will be undertaken directly with practices as well with the Local Medical Committee. No direct or indirect impact noted.
GP access; expectations in respect of extended and core hours National standards and guidance for commissioners GP Core Contract and Extended Hours Directed Enhanced Service (DES) Access Arrangements in Wiltshire Context and background The General Medical Services (GMS) and Personal Medical Services (PMS) Regulations require general practice contractors to provide essential and additional services at such times within core hours,.(that) are appropriate to meet the reasonable needs of patients, and require the contractor to have in place arrangements for its patients to access those services throughout core hours in case of emergency. Core hours for GMS practices are 8:00 18:30, Monday Friday, excluding weekends and bank holidays. Opening hours for PMS and APMS practices are set out in their contract but largely mirror GMS opening hours or longer. The Public Accounts Committee (PAC) report into GP access held in March 2017 set out a number of recommendations. One was to ensure that no practice that was closed weekly for half a day should be in receipt of additional funds to provide extended hours i.e. outside core hours and secondly that patients should know what they can reasonably expect of their GP practice during core hours Guidance has been drafted to help commissioners to work with their providers of general practice in respect of the services that they offer to patients during core hours as well as the conditions that should govern the commissioning of extended hours Specifically it considers the issues surrounding the subcontracting of services during core hours Core Hours The wording of the GMS contract permits practices to subcontract their services during core hours with the approval of the commissioner. As there is no limitation within the contract to the number of hours that can be subcontracted, commissioner approval is central in determining what is acceptable or unacceptable. In-hours Sub-contract Arrangements in Wiltshire There are a number of reasons why a practice may opt to close their surgery for a short period of time including practical operational considerations e.g. for team training or reviewing the quality of services. The contract however does not support a closure during core hours without alternative arrangements being in place to provide services. 1
In Wiltshire we currently have seven practices that report to have half days closures, five with arrangements in place, some with local practices and others of whom no full details have been provided of the sub-contracted arrangements. The CCG has however been assured the subcontracting practice has full access to patient notes. When the surgery is closed the incoming calls are automatically transferred to the sub-contracted practice and patients are aware of the arrangements through normal practice communication methods. It should also be noted, two surgeries have also reported to close their main surgery for a mid-week half day session, but have also noted patients are still able to access their branch surgery at this time. Finally only one practice has informed the CCG following the review they will cease their extended hours and remain closed for half a day each week. The CCG continues to try and engage with the contractor through the Local Medical Committee to understand the barriers to changing or alternative options to provision. Full details of practices reported opening hours are available in appendix one. In-hours Short Period Closures in Wiltshire (Team Training etc.) Nationally practice closures according to the practice electronic declaration (as at December 16/17) indicated that 53% of practices reported their reception to be closed for 30 minutes, on at least one day a week and 25% of practices closed for 30 minutes every day during the week. This could be a short closure for lunch, opening at 08:30 instead of 08:00, or perhaps closing at 18:00 instead of 18:30. At the other end of the spectrum one in seven GP practices close for a half day every week. In Wiltshire the headlines are slightly better; with 30% of practices reporting their reception desk to open later than 08:00, 18% reporting their reception desk to close earlier than 18:30, 20% reporting their reception desk closes for lunch and 12% close for half a day within the week. Only one practice has reported it routinely closes for one hour every month for an in-hours short period closure for a practice meeting. Interestingly one practice has also reported it closes its reception desk routinely at 17:00 three times a week and another who has reported it closes its reception desk routinely at 16:00 every Monday, 15:00 every Wednesday and 17:00 every Friday. Contractual Definitions There has never been a national standard or definition of what constitutes appropriate to meet the reasonable needs of patients and as a result there have been multiple historical interpretations and arrangements in place for practices that close during core hours, some of which have been in place for many years and dating back to days when commercial/retail outlets closed routinely. 2
GMS (Schedule 3, Part 5, Sub contracting) 44. (1) Subject to sub-paragraph (2), the contractor must not sub-contract any of its rights or duties under the contract in relation to clinical matters to any person unless- (a) In all cases, including those duties relating to out of hours services to which paragraph 45 applies, it has taken reasonable steps to satisfy itself that- (i) (ii) It is reasonable in all the circumstances to do so, and The person to whom any of those rights or duties is sub-contracted is qualified and competent to provide the service; and Furthermore (b) Except in cases to which paragraph 45 applies, the contractor has given notice in writing to the board of its intention to sub contract as soon as reasonably practicable before the date on which the proposed sub-contract is intended to come into effect (2) Sub-paragraph (1)(b) does not apply to a contract for services with a health care professional for the provision by that professional personally of clinical services (3) A notice given under sub-paragraph (1)(b) must include- (a) the name and address of the proposed sub-contractor; (b) the duration of the proposed sub-contract (c) the services to be covered by the proposed sub-contract; and (d) the address of any premises to be used for the provision of services under the proposed sub-contract (5) The contractor must not proceed with a sub-contract or, if the sub-contract has already taken effect, the contractor must take steps to terminate it, where (a) (a) the Board gives notice in writing of its objection to the sub-contract on the grounds that the sub-contract would (i) put the safety of the contractor s patients at serious risk, or (ii) put the Board at risk of material financial loss, and notice is given by the Board before the end of the period of 28 days beginning with the date on which the Board received a notice from the contractor under sub-paragraph (1)(b); or (b) the sub-contractor would be unable to meet the contractor s obligations under the contract. Paragraph 45 relates to sub-contracting of out of hours services. 3
PMS (Schedule 2, Part 5, Sub-Contracting) 43. (1) the contractor must not sub-contract any of its rights or duties under the agreement in relation to clinical matters to any person unless it has taken reasonable steps to satisfy itself that- (a) it is reasonable in all the circumstances to do so; (b) the person to whom any of those rights or duties is sub-contracted is qualified and competent to provide the service; and (c) the person holds adequate insurance in accordance with regulation 83 (2) Where the contractor sub-contracts any of its rights or duties under the agreement in relation to clinical matters, it must- (a) inform the board of the sub-contract as soon as reasonable practicable; and (b) provide the board with such information in relation to the subcontract as the board may reasonably request Services that should be available during core hours (including in subcontracted arrangements) Some practices have established a sub-contracted arrangement using local providers. Some of these arrangements will have developed to improve system resilience and would be recognised as a development towards at scale working, underpinning primary care transformation and delivery of the GP forward view. What is not acceptable however is where arrangements are a signposting service only directing patients to urgent care providers. In Wiltshire, for those who reported their half day closures, the CCG has received assurances from the practice signposting is not in place. 4
Half Day Closures Details of Sub-contracting Arrangements in Wiltshire Full details are provided in appendix two. Name of Current List Size Contract Type Details of the arrangement Old School House 3721 PMS The practice has informed the CCG via email and reported via electronic declaration they close every Thursday afternoon. Assurance received the practice complies with reasonable access but no details of the sub-contracted arrangements are held Burbage Surgery 3754 PMS The practice has formally informed the CCG and via electronic declaration they close every Wednesday afternoon. Assurance received the practice complies with reasonable access but no details of the subcontracted arrangements are held Orchard Partnership (Spring Orchard, Fovant Surgery) 11113 (across Partnership) GMS The Spring Orchard practice has informed the CCG via email, but not via electronic declaration they close on a Wednesday afternoon. The phones transfer to Hindon, GP can see face to face, or home visit. They have access to TPP notes. However, the practice has three other sites available, of which registered patients have full access to services available if they wish to Hindon Surgery 2403 GMS The practice has informed the CCG via email and has reported via electronic declaration to close every Tuesday afternoon. Phones transfer to Orchard, GP can see face to face, or home visit. They have access to TPP notes. Also aware from electronic declaration analysis the practice reports to close at 5pm and phones divert to duty doctor which is the Senior Partner via his mobile. He has confirmed full access to notes Silton 1896 PMS The practice has formally informed the CCG and reported via electronic declaration they close at 3pm every Wednesday. No sub-contracting arrangement is in place. Jubilee Field 4559 PMS The practice has formally informed the CCG and reported via electronic declaration they close every Thursday afternoon. No details held of the subcontract arrangements as yet. Sixpenny Handley 4244 PMS The practice has now informed the CCG of the closure and reported via electronic declaration they close every Tuesday afternoon. The practice also has 5
a branch surgery that is open on a Tuesday afternoon and patients have full access available in this period. It should be noted all practices currently provide extended access. Formal confirmation of continuation and an assessment of the sub-contracting arrangements is underway for the continuation of this service for 2018-19. A similar review of all short term closures including late opening i.e. reception opening at 08.30, lunchtime closures and early closing i.e. reception closing at 18.00 has found 30% of practices reporting their reception desk to open later than 08:00, 18% reporting their reception desk to close earlier than 18:30, 20% reporting their reception desk closes for lunch. NHSE have also supplied a key lines of enquiry (KLOE) document they expect CCG s to use (and will be reported on) to work with practices to review their opening hours (appendix three). In order to provide a more targeted approach the practices shown below fit into more than one box, i.e. late opening and lunchtime close. 6
Below is a summary of these practices including their contract type and number of hours lost to the NHS each week based on the core GMS criteria. Name of Current List Size Contract Type Closure Type Hours Lost per week Patford House 8844 GMS Reception opens 08.30 every day Reception closes 18.00 every day 5 Burbage 3754 PMS Reception opens 08.30 every day Reception closes for lunch 13.00-14.00 Mere 4615 GMS Reception opens 08.30 every day closes every Tuesday, Thursday and Friday at 17.00 Jubilee Field 4559 PMS Reception opens at 08.30 every day Reception closes for lunch 13.00-14.00 closes every Tuesday and Friday 18.00 Silton 1896 PMS Reception opens 08.30 every day will continue half day closure every Wednesday closes Monday 16.00, Wednesday 15.00 and Friday 17.00 Whiteparish 6699 GMS Reception opens 08.15 every day Reception closes for lunch 13.00-14.15 7.5 10 8.5 10 7.5 Assessment of Sub-contractual Arrangements Sub-contracting arrangements will need to be assessed to ensure that the arrangements in place are considered adequate contractually and there are a number of suggestions below to guide commissioners in making that assessment. Where sub-contracting arrangements exist, the requirements differ between GMS and PMS contracts. The regulations state that GMS contractors have to give notice (in writing) {to the commissioner} regarding sub-contracting arrangements and the board has the right to object to any such arrangements whereas under PMS arrangements, the contractor need only inform the board {commissioner} of the sub-contracting arrangement. The services listed below have been distilled following engagement with patient groups and patient representatives so whilst not explicit in the contract these represent in broad terms the types of services that we expect will form the basis of discussions with practices; Ability to attend a pre-bookable appointment (face to face) Ability to book / cancel appointments Ability to collect/order a prescription Access urgent appointments / advice as clinically necessary Home visit (where clinically necessary) 7
Ring for telephone advice Ability to be referred to other services where clinically urgent. (including for example suspected cancer) Ability to access urgent diagnostics and take action in relation to urgent results Considerations for the Commissioner when approving Sub-contracting arrangements (assume GMS only) NHS England has provided a few suggestions for Commissioners to consider before making a decision about approving sub-contractual arrangements. They include: Consulting with patients (through the PPG 1 ) about both the need for the closure so that they understand the context and the proposed sub-contracted arrangements and commissioner approval should take account of their views. Patients knowing in advance of the closure and not arriving at the practice to find it closed. During core hours a patient needs to be able to speak to a receptionist or clinician over the phone not given an answering machine message i.e. either at the sub contracted practice or the patients responsible practice. Patients should not have to redial another number as this could cause a delay which might jeopardise patient safety If telephone calls are diverted to a sub-contractor the responder should treat these patients as they would their own registered patients. The sub-contractor must be able to have access to the patient s clinical record (not just the summary care record) again in the interests of patient safety. Where practices close for training purposes, these dates should alternate so it is not the same day each time. Any alternative service should be local or easily accessible by public transport so that there is no need for excessive travel on the part of the patient (and/or their carer). This especially important for elderly or fragile patients. Commissioners will need to be assured that there is no duplication of payments for example provision of seven day access. All sub-contracted arrangements must be resourced by the practice(s) wishing to sub-contract essential services during core hours. Suggested Evaluation of local arrangements NHS England suggests the following data to be used for evaluation of the local arrangement: Patient feedback (Family & friends test / GP Patient Survey / patient complaints) Triangulation with other activity data e.g. A&E / admission activity etc. 1 Commissioners should make sure that the PPG has reasonable representation of the patient population, or, if not, should engage with patients of the practice through a different medium to gain an understanding of the support or concerns of the patient population 8
Extended hours Directed Enhanced Service (DES) Summary of service These are additional hours (National average three hours per practice) usually provided during the week or on a Saturday morning, distinct from any other CCG funded access initiative. The intention behind the DES is to pay additional funds to practices for providing additional hours of service i.e. additional to core hours. Therefore the policy intention is to only pay practices the DES funding on that basis. Following negotiations with the GPC an amendment has been made to the extended hours DES directions such that as at the 1st October 2017, a practice only qualifies for the DES if; the contractor s practice is not closed for half a day on a weekly basis unless by written prior agreement of the board and a requirement that patients must be able to access essential services during core hours from the contractors practice or from any person who is sub-contracted during core hours NHS England s response to the DES changes notes some practices (supported by CCGs) have established a sub contractual arrangement using local providers similarly to the sub contracted arrangements that have been established to meet the core hour s requirement. Whilst these arrangements support the principles of at scale working, they do not reflect the policy intention which underpinned the negotiations regarding the Extended Hours DES. Extended hours Sub-contract Arrangements in Wiltshire Whilst the revised directions give a degree of flexibility i.e. with prior agreement of the board, ; use of this flexibility is considered highly exceptional requiring commissioner (NHS England or delegated CCG COO) plus NHS England regional director support and finally sign off by the National Director. Any sub-contracted arrangements must meet all of the requirements outlined above but also ensure that the overall appointment capacity delivered by the sub-contracted arrangements increases patients ability to seek advice or appointments to see a clinician across those practices involved (in the host provider and also sub-contractor), with in addition, where commissioned, extended access capacity being maintained as well. There are no known extended hour s sub-contracted arrangements in Wiltshire. Plan for review The plan for review will include considering the 2017/18 GP contract electronic declaration, the biannual access collection and any local intelligence in identifying those practices that are closed routinely during core hours. NHS England expects commissioners to prioritise conversations with those practices that are closed for the longest periods with a particular focus on: 9
1. s that are intending to remain closed for half a day weekly and who continue to claim DES funding (see para 21 on process to be adopted for approval). Commissioners will be expected to reclaim any DES related funding post 1 st October 2017; 2. practices that plan to surrender the extended hours DES funding and continue to close for half a day weekly as this would result in both reduced access and a poorer service for those patients; 3. practices with half day closing arrangements whose GP Patient Survey data is a negative outlier in terms of accessibility against the CCG average; 4. practices that declare a period of closure where a significantly higher number of patients attend and emergency department compared to a CCG average suggesting the patients needs are not truly being met. NHS England recommends that practices should be given the opportunity to substantiate with evidence that they are meeting their reasonable needs during a routine closure and this should include how they have engaged patients and worked with their PPG to properly consider the impact of any sub-contracted arrangement, in particular on the elderly, less mobile or patients with protected characteristics. Commissioners are asked to form a judgment on the test of meeting reasonable need using as a guide; The services described in the previous section of assessment of sub-contractual arrangements (appendix three); the evidence provided by the practice including patient views and opinions; the impact on the rest of the health system e.g. the contribution of a practice closure may be having on secondary or community care provision. NHS England expects commissioners should also consider what benefits will be realised by choosing a sub-contracted model over being open during the full core hours period. Wiltshire CCG s Primary Care Commissioning Committee is expected to make a decision for all practices operating a subcontracting arrangement and whether to allow practices to closure during core hours. NHS England anticipates the change to some historical arrangements will take time to effect and commissioners should consider the support that practices may require in addressing the new requirements including agreeing an appropriate pace of any change e.g. appropriate alternative arrangements negotiated or an amendment to terms and conditions of employed staff. It is expected however that the necessary arrangements will be put in place by April 2018. 10
Next Steps There are a number of actions the CCG as Commissioner needs to undertake starting with an assessment of the current sub-contractual arrangements in place for GMS practices and ensure the CCG has all reasonable information needed for sub-contractual arrangements in PMS practices. For GMS practices this will include patient feedback and Emergency Department attendance data. Wiltshire Summary of Actions Continue to engage with both the through the Local Medical Committee and the contractor who now wishes to cease extended hours to understand the barriers to changing or alternative options to provision. Review all other known current sub-contractual arrangements against criteria. Develop a standard proforma for practices to apply for in-hours closure. Undertake a mid-year evaluation of all extended hours arrangements. Collate all practices training dates throughout the year to ensure these vary as per the guidance. After assessment of the sub-contractual arrangements in place during core hours has been completed and where there is a dispute between the commissioner and the practice either on the services available or the sub-contracted arrangements in place or proposed then commissioners may need to consider contractual action. s who decide to withdraw from the extended hours DES and therefore the provision of extended hours, should be reminded of their responsibilities to inform patients and ensure sufficient notice and minimum disruption. Contractual measures NHS England recommends for practices that are found to be in breach of contract, remedial notices will be required to agree a reasonable and proportionate pace of change and on-going dialogue between the commissioner/practice on progress and failure to respond would result in a Breach notice. NHS England Reporting NHS England expects commissioners to report progress on this requirement via the Primary Care Activity Report between November 2017 and April 2018 including what if any contractual action has been taken. Produced by: Victoria Stanley Primary Care Commissioning Manager Thursday 31 st May 2018 11
Appendix One - General Reported Opening Hours Data OrgCode Name Comments on Monday opening hours Comments on Tuesday opening hours Lunch Comments on Wednesday opening hours Comments on Thursday opening hours Comments on Friday opening hours Comments on Saturday opening hours Comments on Sunday opening Opening Lunch Lunch Closing Opening Lunch Lunch Closing Opening Time Lunch Start End Closing Time Opening Lunch Lunch Closing Opening Lunch Lunch Closing Opening Lunch Lunch Closing Opening Lunch Lunch Closing hours Start End Time Start End Time for Wednesday for Wednesday Start End Time Start End Time Start End Time Start End Time Monday for Monday Tuesday for Tuesday Wednesday Wednesday Thursday for Thursday Friday for Friday Friday Saturday for Saturday Sunday for Sunday Monday Monday Tuesday Tuesday Thursday Thursday Friday Saturday Saturday Sunday Sunday Extended hours in locality at Southbroom 18:30 J83034 Lansdowne Surgery GMS 08:00 19:30 19:30 08:00 19:30 Weekly 18:30 19:30 extended hours 08:00 18:30 08:00 18:30 07:30 18:30 7:30 8:00 extended hours weekly Not Open...... Not Open Closed J83037 Kennet & Avon Medical Partnership GMS 08:00...... 19:00 07:30...... 19:00 07:30...... 19:00 07:30...... 19:00 07:30...... 18:30 Not Open Not Open J83039 Northlands Surgery GMS 08:00 20:00 does not close over lunch 08:00 18:30 does not close over lunch 08:00 20:00 does not close over lunch 08:00 18:30 does not close over lunch 08:00 18:30 does not close over lunch 09:00 12:00 Quarterly(min). Surgery closes 11.45am. Not Open... J83040 White Horse Health Centre PMS 08:00 18:30 07:30 18:30 08:00 20:00 08:00 20:00 08:00 18:30 Not Open... 8 10.30 every other week. Not Open J83041 Malmesbury Medical Partnership GMS 08:00 19:00 08:00 19:00 07:30 19:00 07:30 19:00 08:00 19:00 08:30 12:00 Not Open J83042 Rowden Medical PMS 08:00 19:30 08:00 18:30 07:00 18:30 08:00 18:30 07:00 18:30 Not Open Not Open J83043 Downton Surgery GMS 08:00 18:30 late opening 08:00 18:30 early/late opening 08:00 18:30 early opening 08:00 18:30 08:00 18:30 Not Open Not Open J83045 Ramsbury & Wanborough Surgery GMS 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:15 12:00 Shut at 1130 Not Open J83046 Spa Medical Centre GMS 08:00 18:30 07:30 18:30 07:30 19:30 08:00 19:30 08:00 18:30 Not Open Not open Not Open Not open J83048 St Melor House Surgery GMS 07:30 18:00 telephone access to 1830 08:00 19:00 telephone access to 1830 07:30 18:00 telephone access to 1830 08:00 18:00 telephone access to 1830 08:00 18:00 telephone access to 1830 Not Open Not Open J83006 Purton Surgery GMS 08:00...... 18:30 08:00...... 18:30 08:00...... 18:30 08:00...... 18:30 08:00...... 18:30 Not Open... Not Open J83007 Hathaway Medical Centre PMS 07:00 19:30 Extended Hours, multiple clinicians 07:30 18:30 Extended Hours, multiple clinicians 07:00 19:00 Extended Hours, multiple clinicians 08:00 18:30 08:00 18:30 Not Open Not Open J83008 Lovemead Group PMS 08:00 19:30 Extended hours from 18:30 to 19:30 08:00 18:30 08:00 19:30 Extended hours from 18:30 to 19:30 08:00 19:30 Extended hours from 18:30 to 19:30 08:00 18:30 08:30 12:00 Open alternate Saturdays until 10.30am Not Open Closed on Sunday Early Surgeries (07:15 start) once a week. Late Early Surgeries (07:15 start) once a week. Late Early Surgeries (07:15 start) once a week. Late Early Surgeries (07:15 start) once a week. Late Early Surgeries (07:15 start) once a week. Late J83010 Porch Surgery GMS 08:00 12:30 13:30 18:30 Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Surgery (19.15 finish) once a week 08:30... 12:00 Alternate Saturday mornings Not Open We are open from 8am, but the doors don't open We are open from 8am, but the doors don't We are open from 8am, but the doors don't open We are open from 8am, but the doors don't open We are open from 8am, but the doors don't J83011 Giffords Primary Care Centre GMS 08:30 19:30 until 8.30am each morning 08:30 19:30 open until 8.30am each morning 08:30 18:30 until 8.30am each morning 08:30 18:30 until 8.30am each morning 08:30 18:30 open until 8.30am each morning Not Open Closed Not Open Closed J83013 Box Surgery GMS 08:00 13:00 14:00 18:30 see Supporting Information 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 09:00... 12:00 one Saturday in 3 Not Open J83014 Castle PMS 08:00 18:30 Extended hours THC pm until 20:00hrs 07:00 18:30 Extended hours LHC am from 07:00hrs 08:00 18:30 08:00 18:30 Ext hrs THC pm until 20:00hrs 08:00 18:30 Not Open Not Open J83016 Trowbridge Health Centre (formally Adcroft Surgery) PMS 08:30 19:30 08:30 19:30 07:00 18:30 08:30 19:30 07:00 18:30 Not Open Not Open J83018 Avenue Surgery GMS 08:00 20:00 Extended Hours 18:30 20:00 08:00 20:00 Extended hours 18.30 20.00 07:30 20:00 Extended hours 7.30 8.00 / 18:30 20:00 08:00 20:00 Extended Hours 18:30 20:00 07:30 18:30 Extended hours 7.30 8.00 Not Open Closed Not Open Closed Extended hours 09.00 to 12.00 Every 2nd and 4th Saturday in the month Spring Orchard Surgery. Extended hours 18.30 to 19.30 Old Orchard Extended hours 07.15 to 08.00 Cherry Orchard Extended hours 07.30 to 08.00 every Wednesday at Extended hours 18.30 to 19.30 Cherry Orchard and Every 3rd Saturday in the month Till Orchard J83019 Orchard Partnership GMS 08:00 18:30 Surgery 08:00 18:30 Surgery, a 08:00 18:30 Old Orchard Surgery 08:00 18:30 Old Orchard 08:00 18:30 Not Open Surgery Not Open J83021 Salisbury Medical GMS 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only Not Open... Not Open J83023 Avon Valley GMS 08:00 13:00 14:00 19:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch Not Open 13:00 14:00 18:30 Not Open 13:00 14:00 18:30 J83026 Three Chequers GMS 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83029 Tinkers Lane Surgery GMS 08:30 18:30 08:30 18:30 07:30 20:00 08:30 20:00 08:30 18:30 Not Open Not Open Extended hours 0730 0800 at one site +Extended J83030 Bradford on Avon & Melksham Health Centre GMS 08:15 20:00 Extended hours telephone calls 08:15 18:30 +Extended hours telephone calls from 6.30pm 08:15 18:30 +Extended hours telephone calls from 6.30pm 08:15 18:30 +Extended hours telephone calls from 6.30pm 08:15 18:30 hours telephone calls from 6.30pm Not Open Not Open J83049 Southbroom Surgery PMS 08:00 19:30 Open All Day 07:30 18:30 Open All Day 07:30 18:30 Open All Day 08:00 18:30 Open All Day 07:30 18:30 Open All Day Not Open Not Open Not Open Not Open J83050 Patford House Surgery GMS 08:30...... 18:00 08:30...... 18:00 08:30...... 18:00 08:30...... 18:00 08:30...... 18:00 Not Open Not Open J83052 MillStream Medical Centre GMS 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 until 7.00 for patients too when required 06:00 18:30 08:00 12:00 if required Not Open J83053 St James Surgery GMS 07:30 18:30 We do not close during the day 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open We are not open on saturday Not Open we are not open on sunday J83055 New Court Surgery GMS 08:00 18:30 07:30 18:30 07:30 20:00 07:30 18:30 08:00 19:45 Not Open Not Open J83056 Market Lavington Surgery GMS 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime Not Open Not Open J83058 Tisbury Surgery GMS 08:00 18:30 We do not close for lunch 08:00 18:30 + 18:30 19:45 alternate weeks 08:00 18:30 + 18:30 19:45 alternate weeks 08:00 18:30 08:00 18:30 09:00 11:00 Open for 2 hours 1st Sat each month Not Open J83060 Mere Surgery GMS 08:30 20:00 Monday Extended Surgery 6.30 8.00pm 08:30 17:00 08:30 18:30 Surgery open 8.00am alternate weeks 08:30 17:00 08:30 17:00 Not Open Not Open J83636 Beversbrook Medical Centre PMS 07:00 18:30 7.00 8.00 for EH 08:30 18:30 Phone lines open from 8.00 08:30 18:30 Phone lines open from 8.00 08:30 18:30 Phone lines open from 8.00 08:30 18:30 Phone lines open from 8.00 Not Open Closed Not Open Closed closed for lunch Mon FRri to walk in patients J83643 #N/A #N/A 08:00 13:00 14:00 18:30 but with full access by telephone 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 07:30 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open J83601 Burbage Surgery PMS 08:30 13:00 14:00 18:45 will close at 18.30 if no late appt booked 08:30 13:00 14:00 19:00 Will close at 18.30 if no late appt booked 08:30 12:00 12:00 12:00 PM covered by another local practice 08:30 13:00 14:00 18:45 will close at 18.30 if no late appointments 08:30 13:00 14:00 18:30 Not Open Not Open J83603 Jubilee Field Surgery PMS 08:30 13:00 14:00 19:00 08:30 13:00 14:00 18:00 08:30 13:00 14:00 20:00 08:30 13:00 13:00 13:00 08:30 13:00 14:00 18:00 Not Open Not Open J83609 Cricklade Surgery GMS 08:30 19:00 Not closed for lunch. 08:30 18:30 Not closed for lunch 08:30 19:00 Not closed for lunch. 08:30 19:00 Not closed for lunch. 08:30 18:30 Not closed for lunch. Not Open Not closed for lunch. Not Open Not closed for lunch. Closed pm alternative cover provided by J83615 Old School House Surgery PMS 08:30 18:30 08:30 19:30 08:30 18:30 08:30 12:00 Burbage Surgery 09:00 18:30 Not Open Not Open J83618 Tolsey Surgery PMS 08:30 18:30 08:30 18:30 07:30 19:30 08:30 19:30 08:30 18:30 Not Open Not Open J83619 Courtyard Surgery GMS 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 19:15 Not Open Not Open J83625 Lodge Surgery PMS 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open Walk in surgery is held at Maiden Bradley on a One thursday per month, we close the door and J83629 Silton Surgery PMS 08:30 16:00 Monday evening 5 6pm 08:30 19:00 Extended hours Tues Pm 08:30 15:00 Clinicians on call till 15.00 08:30 18:45 phone for 1 hour for practice meeting. 08:30 17:00 Not Open Not Open Staffed and open continuously with no lunch Staffed and open continuously with no lunch From 12 noon emergency calls transferred to break, between 1700 and 1830 calls transfer to Staffed and open continuously with no lunch J83630 Hindon Surgery GMS 08:00 18:30 break 08:00 12:00 Fovant Surgery until 1830 08:00 18:30 Staffed and open continuously with no lunch break 08:00 17:00 duty GP mobile number 08:00 18:30 break Not Open We do not routinely open at weekends Not Open We do not routinely open at weekends J83632 Cross Plain Health Centre GMS 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open J81083 Sixpenny Handley PMS 08:00 13:00 14:00 21:00 08:00...... 13:00 Closed Tuesday pm 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open every Monday we open for extended access at we every tuesday we open for extended access every Wednesday we open for extended access at J83003 Harcourt Medical Centre GMS 08:00 18:30 7.30am and close at 7.30pm 08:00 18:30 at 7.30am 08:00 18:30 7.30am 08:00 18:30 we open at 7.15 for extended access 08:00 18:30 we open at 7.30 for extended access Not Open Not Open J83004 Whiteparish Surgery GMS 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:45...... 12:00 pre booked appointments Not Open J83005 Barcroft Medical GMS 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 Not Open 09:00 11:00 Extended Hours Monthly Not Open 14 11 3 14 10 5 (2 half day) 12 11 4 (2 half day) 15 4 (2 half day closures) 13 11 4 12
Comment Comment Telephon Telephon Comment s on Comment Comment Comment Comment s on Telephon Telephon s on Telephon e Lunch e Lunch Wednesd Telephon Telephon s on s on Telephon s on Telephon Telephon s on Telephon Monday Telephon e Lunch e Lunch Telephon Tuesday e Opening Start Time End Time Closing ay Telephon e Lunch e Lunch Telephon Thursday Telephon Telephon Telephon Telephon Friday Telephon e Lunch Telephon Saturday Telephon e Lunch e Lunch Telephon Sunday e Closing Telephon e Opening Start Time End Time e Closing Telephon for for Telephon e Opening Start Time End Time e Closing Telephon e Opening e Lunch e Lunch e Closing Telephon e Opening Start Time Lunch End e Closing Telephon e Opening Start Time End Time e Closing Telephon e opening for for e opening Wednesd Wednesd Wednesd Wednesd e opening for for e opening Start Time End Time e opening for e opening for for e opening OrgCode Monday hours Tuesday Tuesday Tuesday Tuesday hours ay ay ay ay hours Thursday Thursday Thursday Thursday hours Friday for Friday for Friday Friday hours Saturday Saturday Saturday Saturday hours Saturday Sunday Sunday Sunday hours J83034 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83037 18:30 08:30 18:30 08:30 18:30 08:30 18:30 08:30 18:30 Not Open Not Open J83039 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open......... Not Open......... J83040 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open... Not Open J83041 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83042 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83043 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open 18:30 Not Open 18:30 J83045 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:15 12:00 1130 Not Open J83046 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 Not Open...... Not Open J83048 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83006 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83007 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open......... Not Open......... J83008 18:30 Emergency08:00 12:30 14:00 18:30 Emergency08:00 12:30 14:00 18:30 Emergency08:00 12:30 14:00 18:30 Emergency08:00 12:30 14:00 18:30 EmergencyNot Open Phone linesnot Open Closed on Sunday J83010 18:00 Emergency08:00 12:30 13:30 18:00 Emergency08:00 12:15 13:30 18:00 Emergency08:00 12:30 13:30 18:00 Emergency08:00 12:30 13:30 18:00 EmergencyNot Open... Not Open J83011 18:30 Emergency08:30 18:30 Emergency08:30 18:30 Emergency08:30 18:30 Emergency08:30 18:30 EmergencyNot Open Out of HouNot Open Out of Hours Cover J83013 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open... Not Open J83014 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83016 18:30 General Ap08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83018 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 08:30 13:00 14:00 18:30 Not Open Not Open J83019 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83021 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83023 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 J83026 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83029 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83030 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83049 18:30 All Lines Op08:30 18:30 All Lines Op08:30 18:30 All Lines Op08:30 18:30 All Lines Op08:30 18:30 All Lines OpNot Open Not Open Not Open Not Open J83050 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83052 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 12:00 not for telenot Open J83053 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open We are notnot Open we are not open on sunday J83055 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83056 18:30 Emergency08:00 12:30 13:30 18:30 Emergency08:00 12:30 13:30 18:30 Emergency08:00 12:30 13:30 18:30 Emergency08:00 12:30 13:30 18:30 EmergencyNot Open Not Open J83058 18:30 We do not 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open not open Not Open not open J83060 20:00 08:30 17:00 08:30 18:30 08:30 17:00 08:30 17:00 Not Open Not Open J83636 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83643 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83601 18:30 08:00 18:30 08:00 12:00 12:00 12:00 PM covere 08:00 18:30 08:00 18:30 Not Open Not Open J83603 18:00 08:30 13:00 14:00 18:00 08:30 13:00 14:00 18:00 08:30 13:00 13:00 13:00 08:30 13:00 14:00 18:00 Not Open Not Open J83609 18:30 not closed 08:00 18:30 not closed 08:00 18:30 not closed 08:00 18:30 not closed 08:00 18:30 not closed Not Open Not Open J83615 18:30 09:00 18:30 09:00 18:30 09:00 12:00 see above 09:00 18:30 Not Open Not Open J83618 18:30 08:30 18:30 08:30 18:30 08:30 18:30 08:30 18:30 Not Open Not Open J83619 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 Not Open Not Open J83625 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83629 18:00 08:30 16:30 08:30 15:00 08:30 18:45 08:30 18:00 Not Open Not Open J83630 18:30 08:00 18:30 Calls from 08:00 18:30 08:00 18:30 Calls from 08:00 18:30 Not Open We do not Not Open We do not routinely open at weekends J83632 18:30 sh08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J81083 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83003 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83004 18:30 08:00 18:30 08:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open J83005 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open......... Not Open......... 13
Opening Monday OpeningHoDecDataID DeclarationOrgCode OrgType Parent CCG DCORegionRegion CreatedByNCreatedByICreatedOn SameAsPar Lunch Start Monday Lunch End Time for Monday Closing Monday Opening Tuesday Lunch Start Tuesday Lunch End Time for Tuesday Closing Tuesday Lunch Start Opening Time for Wednesday Wednesday Lunch End Wednesday Comments on Monday opening hours Comments on Tuesday opening hours Extended hours in locality at Southbroom 18:30 19:30 08:00 19:30 Weekly 18:30 19:30 extended hours 08:00 18:30 22223 92387 8 J83034 P J83034 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 19:30 22226 92390 8 J83037 P J83037 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00...... 19:00 07:30...... 19:00 07:30...... 19:00 22228 92392 8 J83039 P J83039 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 20:00 does not close over lunch 08:00 18:30 does not close over lunch 08:00 20:00 22229 92393 8 J83040 P J83040 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 07:30 18:30 08:00 20:00 22230 92394 8 J83041 P J83041 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 19:00 08:00 19:00 07:30 19:00 22231 92395 8 J83042 P J83042 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 19:30 08:00 18:30 07:00 18:30 22232 92396 8 J83043 P J83043 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 late opening 08:00 18:30 early/late opening 08:00 18:30 22233 92397 8 J83045 P J83045 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:30 18:30 22234 92398 8 J83046 P J83046 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 07:30 18:30 07:30 19:30 22236 92400 8 J83048 P J83048 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 07:30 18:00 telephone access to 1830 08:00 19:00 telephone access to 1830 07:30 18:00 22201 92365 8 J83006 P J83006 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00...... 18:30 08:00...... 18:30 08:00...... 18:30 22202 92366 8 J83007 P J83007 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 07:00 19:30 Extended Hours, multiple clinicians 07:30 18:30 Extended Hours, multiple clinicians 07:00 19:00 22203 92367 8 J83008 P J83008 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 19:30 Extended hours from 18:30 to 19:30 08:00 18:30 08:00 19:30 22205 92369 8 J83010 P J83010 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 12:30 13:30 18:30 Early Surgeries (07:15 start) once a week. Late Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Early Surgeries (07:15 start) once a week. Late Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 22206 92370 8 J83011 P J83011 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 19:30 We are open from 8am, but the doors don't open until 8.30am each morning 08:30 19:30 We are open from 8am, but the doors don't open until 8.30am each morning 08:30 18:30 22207 92371 8 J83013 P J83013 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 13:00 14:00 18:30 see Supporting Information 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 22208 92372 8 J83014 P J83014 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 Extended hours THC pm until 20:00hrs 07:00 18:30 Extended hours LHC am from 07:00hrs 08:00 18:30 22209 92373 8 J83016 P J83016 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 19:30 08:30 19:30 07:00 18:30 22210 92374 8 J83018 P J83018 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 20:00 Extended Hours 18:30 20:00 08:00 20:00 Extended hours 18.30 20.00 07:30 20:00 Closing Wednesday 22211 92375 8 J83019 P J83019 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 Extended hours 18.30 to 19.30 Old Orchard Surgery 08:00 18:30 Extended hours 07.15 to 08.00 Cherry Orchard Surgery, a 08:00 18:30 22212 92376 8 J83021 P J83021 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 22214 92378 8 J83023 P J83023 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 13:00 14:00 19:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch 08:00 13:00 14:00 18:30 22217 92381 8 J83026 P J83026 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 08:00 18:30 08:00 18:30 22219 92383 8 J83029 P J83029 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 18:30 08:30 18:30 07:30 20:00 22220 92384 8 J83030 P J83030 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:15 20:00 Extended hours telephone calls 08:15 18:30 +Extended hours telephone calls from 6.30pm 08:15 18:30 22237 92401 8 J83049 P J83049 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 19:30 Open All Day 07:30 18:30 Open All Day 07:30 18:30 22238 92402 8 J83050 P J83050 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30...... 18:00 08:30...... 18:00 08:30...... 18:00 22239 92403 8 J83052 P J83052 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 08:00 18:30 08:00 18:30 22240 92404 8 J83053 P J83053 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 07:30 18:30 We do not close during the day 08:00 18:30 08:00 18:30 22242 92406 8 J83055 P J83055 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 07:30 18:30 07:30 20:00 22243 92407 8 J83056 P J83056 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 22245 92409 8 J83058 P J83058 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 We do not close for lunch 08:00 18:30 + 18:30 19:45 alternate weeks 08:00 18:30 22247 92411 8 J83060 P J83060 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 20:00 Monday Extended Surgery 6.30 8.00pm 08:30 17:00 08:30 18:30 22261 92425 8 J83636 P J83636 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 07:00 18:30 7.00 8.00 for EH 08:30 18:30 Phone lines open from 8.00 08:30 18:30 22262 92426 8 J83643 P J83643 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 13:00 14:00 18:30 closed for lunch Mon FRri to walk in patients but with full access by telephone 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 22250 92414 8 J83601 P J83601 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 13:00 14:00 18:45 will close at 18.30 if no late appt booked 08:30 13:00 14:00 19:00 Will close at 18.30 if no late appt booked 08:30 12:00 12:00 12:00 22251 92415 8 J83603 P J83603 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 13:00 14:00 19:00 08:30 13:00 14:00 18:00 08:30 13:00 14:00 20:00 22252 92416 8 J83609 P J83609 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 19:00 Not closed for lunch. 08:30 18:30 Not closed for lunch 08:30 19:00 22253 92417 8 J83615 P J83615 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 18:30 08:30 19:30 08:30 18:30 22254 92418 8 J83618 P J83618 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 18:30 08:30 18:30 07:30 19:30 22255 92419 8 J83619 P J83619 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 08:00 12:30 13:30 18:30 22256 92420 8 J83625 P J83625 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 08:00 18:30 08:00 18:30 22257 92421 8 J83629 P J83629 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:30 16:00 Walk in surgery is held at Maiden Bradley on a Monday evening 5 6pm 08:30 19:00 Extended hours Tues Pm 08:30 15:00 22258 92422 8 J83630 P J83630 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 Staffed and open continuously with no lunch break 08:00 12:00 From 12 noon emergency calls transferred to Fovant Surgery until 1830 08:00 18:30 22259 92423 8 J83632 P J83632 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 22005 92169 8 J81083 P J81083 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 13:00 14:00 21:00 08:00...... 13:00 Closed Tuesday pm 08:00 13:00 14:00 18:30 29778 92169 8 J81083001 B J81083 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:48:57 08:00 13:00...... Closed pm 08:00 13:00 14:00 18:30 29872 92365 8 J83006001 B J83006 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:48:59 08:30 12:30 14:00 18:30 08:30 12:30 08:30 12:30 29873 92366 8 J83007001 B J83007 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29875 92371 8 J83013001 B J83013 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 Not Open 08:30 12:00 08:30 12:00 29876 92372 8 J83014002 B J83014 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:00 20:00 08:00 17:30 08:00 17:30 29877 92375 8 J83019001 B J83019 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29878 92375 8 J83019002 B J83019 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29879 92375 8 J83019003 B J83019 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29880 92376 8 J83021001 B J83021 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:00 18:00 08:00 13:00 08:00 18:00 29881 92376 8 J83021002 B J83021 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:00 18:00 08:00 18:00 08:00 13:00 29882 92376 8 J83021003 B J83021 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:00 18:00 Extended Hours once a week till 2000 08:00 18:00 Extended Hours once a week till 2000 08:00 18:00 29884 92378 8 J83023001 B J83023 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29885 92381 8 J83026001 B J83026 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:15 17:00 09:00 17:00 08:30 12:30 29886 92384 8 J83030001 B J83030 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:30 13:00 14:00 18:00 08:30 13:00 14:00 18:00 08:30 13:00 14:00 18:00 29887 92384 8 J83030002 B J83030 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:15 20:00 08:15 18:30 08:15...... 18:30 29888 92384 8 J83030003 B J83030 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:30 17:30 08:30 17:30 08:30 17:30 29891 92390 8 J83037001 B J83037 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29892 92393 8 J83040001 B J83040 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:30 13:00 08:30 13:00 14:30 17:30 12:00 15:30 29894 92397 8 J83045001 B J83045 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:30... 19:30 Closed between 1200 1615 08:30 18:30 Closed between 1200 1615 08:30 18:30 29895 92402 8 J83050001 B J83050 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:45 12:45 14:00 18:30 08:45 12:45 08:45 12:45 14:30 18:30 29896 92407 8 J83056001 B J83056 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 29898 92416 8 J83609001 B J83609 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 Not Open Not Open 12:00 13:30 29899 92423 8 J83632001 B J83632 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:49:00 08:00 13:00 08:00 18:00 08:00 13:00 22198 92362 8 J83003 P J83003 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 every Monday we open for extended access at 7.30am and close at 7.30pm 08:00 18:30 we every tuesday we open for extended access at 7.30am 08:00 18:30 22199 92363 8 J83004 P J83004 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 22200 92364 8 J83005 P J83005 99N Q82 Y57 SYSTEM 0 12 Nov 2016 17:40:55 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 14
Comments on Wednesday opening hours Opening Thursday Lunch Start Thursday Lunch End Time for Thursday Closing Thursday Comments on Thursday opening hours Opening Friday Lunch Start Friday Lunch End Time for Friday Closing Friday Comments on Friday opening hours Opening Saturday Lunch Start Saturday Lunch End Time for Saturday Closing Saturday Comments on Saturday opening hours Opening Sunday Lunch Start Sunday Lunch End Time for Sunday Closing Sunday Comments on Sunday opening hours 08:00 18:30 07:30 18:30 7:30 8:00 extended hours weekly Not Open...... Not Open Closed 07:30...... 19:00 07:30...... 18:30 Not Open Not Open does not close over lunch 08:00 18:30 does not close over lunch 08:00 18:30 does not close over lunch 09:00 12:00 Quarterly(min). Surgery closes 11.45am. Not Open... 08:00 20:00 08:00 18:30 Not Open... 8 10.30 every other week. Not Open 07:30 19:00 08:00 19:00 08:30 12:00 Not Open 08:00 18:30 07:00 18:30 Not Open Not Open early opening 08:00 18:30 08:00 18:30 Not Open Not Open Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:30 18:30 Telephone lines open from 0800 08:15 12:00 Shut at 1130 Not Open 08:00 19:30 08:00 18:30 Not Open Not open Not Open Not open telephone access to 1830 08:00 18:00 telephone access to 1830 08:00 18:00 telephone access to 1830 Not Open Not Open 08:00...... 18:30 08:00...... 18:30 Not Open... Not Open Extended Hours, multiple clinicians 08:00 18:30 08:00 18:30 Not Open Not Open Extended hours from 18:30 to 19:30 08:00 19:30 Extended hours from 18:30 to 19:30 08:00 18:30 08:30 12:00 Open alternate Saturdays until 10.30am Not Open Closed on Sunday Early Surgeries (07:15 start) once a week. Late Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Early Surgeries (07:15 start) once a week. Late Surgery (19.15 finish) once a week 08:00 12:30 13:30 18:30 Early Surgeries (07:15 start) once a week. Late Surgery (19.15 finish) once a week 08:30... 12:00 Alternate Saturday mornings Not Open We are open from 8am, but the doors don't open until We are open from 8am, but the doors don't open We are open from 8am, but the doors don't open 8.30am each morning 08:30 18:30 until 8.30am each morning 08:30 18:30 until 8.30am each morning Not Open Closed Not Open Closed 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 09:00... 12:00 one Saturday in 3 Not Open 08:00 18:30 Ext hrs THC pm until 20:00hrs 08:00 18:30 Not Open Not Open 08:30 19:30 07:00 18:30 Not Open Not Open Extended hours 7.30 8.00 / 18:30 20:00 08:00 20:00 Extended Hours 18:30 20:00 07:30 18:30 Extended hours 7.30 8.00 Not Open Closed Not Open Closed Extended hours 07.30 to 08.00 every Wednesday at Old Orchard Surgery 08:00 18:30 Extended hours 18.30 to 19.30 Cherry Orchard and Old Orchard 08:00 18:30 Not Open Extended hours 09.00 to 12.00 Every 2nd and 4th Saturday in the month Spring Orchard Surgery. Every 3rd Saturday in the month Till Orchard Surgery Not Open 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only 08:00 20:00 1830 2000 Booked appointments only Not Open... Not Open phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch 08:00 13:00 14:00 18:30 phone access over lunch Not Open 13:00 14:00 18:30 Not Open 13:00 14:00 18:30 08:00 18:30 08:00 18:30 Not Open Not Open 08:30 20:00 08:30 18:30 Not Open Not Open +Extended hours telephone calls from 6.30pm 08:15 18:30 +Extended hours telephone calls from 6.30pm 08:15 18:30 Extended hours 0730 0800 at one site +Extended hours telephone calls from 6.30pm Not Open Not Open Open All Day 08:00 18:30 Open All Day 07:30 18:30 Open All Day Not Open Not Open Not Open Not Open 08:30...... 18:00 08:30...... 18:00 Not Open Not Open 08:00 18:30 until 7.00 for patients too when required 06:00 18:30 08:00 12:00 if required Not Open 08:00 18:30 08:00 18:30 Not Open We are not open on saturday Not Open we are not open on sunday 07:30 18:30 08:00 19:45 Not Open Not Open Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime 08:00 12:30 13:30 18:30 Emergency cover is provided at lunchtime Not Open Not Open + 18:30 19:45 alternate weeks 08:00 18:30 08:00 18:30 09:00 11:00 Open for 2 hours 1st Sat each month Not Open Surgery open 8.00am alternate weeks 08:30 17:00 08:30 17:00 Not Open Not Open Phone lines open from 8.00 08:30 18:30 Phone lines open from 8.00 08:30 18:30 Phone lines open from 8.00 Not Open Closed Not Open Closed 07:30 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open PM covered by another local practice 08:30 13:00 14:00 18:45 will close at 18.30 if no late appointments 08:30 13:00 14:00 18:30 Not Open Not Open 08:30 13:00 13:00 13:00 08:30 13:00 14:00 18:00 Not Open Not Open Not closed for lunch. 08:30 19:00 Not closed for lunch. 08:30 18:30 Not closed for lunch. Not Open Not closed for lunch. Not Open Not closed for lunch. 08:30 12:00 Closed pm alternative cover provided by Burbage Surgery 09:00 18:30 Not Open Not Open 08:30 19:30 08:30 18:30 Not Open Not Open 08:00 12:30 13:30 18:30 08:00 12:30 13:30 19:15 Not Open Not Open 08:00 18:30 08:00 18:30 Not Open Not Open Clinicians on call till 15.00 08:30 18:45 One thursday per month, we close the door and phone for 1 hour for practice meeting. 08:30 17:00 Not Open Not Open Staffed and open continuously with no lunch break 08:00 17:00 Staffed and open continuously with no lunch break, between 1700 and 1830 calls transfer to duty GP mobile number 08:00 18:30 Staffed and open continuously with no lunch break Not Open We do not routinely open at weekends Not Open We do not routinely open at weekends 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 Not Open Not Open Cloaed all day 08:00 13:00 14:00 18:30 08:00 13:00 14:00 18:30 08:30 12:30 14:30 17:00 08:30 12:30 14:00 17:00 Not Open Not Open Not Open 08:30 12:00 Not Open Not Open 08:00 20:00 08:00 17:30 08:00 18:00 08:00 13:00 08:00 18:00 08:00 13:00 Extended Hours once a week till 2000 08:00 18:00 Extended Hours once a week till 2000 08:00 18:00 Extended Hours once a week till 2000... monthly extended hours on a Sat morning 09:00 12:30 09:00 15:30 08:30 13:00 14:00 18:00 +Extended hours telephone calls from 6.30pm 08:30 13:00 14:00 18:00 hours telephone calls from 6.30pm 08:15 18:30 08:15 18:30 08:30 17:30 08:30 17:30 08:30 13:00 14:30 17:30 08:30 13:00 08:00 10:30 every 3rd Saturday Closed between 1200 1615 08:30 18:30 Closed between 1200 1615 08:30 18:30 Closed between 1200 1615 08:15 10:00 Shut at 0930 not available on the options! 08:45 12:45 14:00 18:30 08:45 12:45 14:00 18:30 Not Open 12:00 13:30 Not Open Not Open 08:00 18:00 08:00 13:00 every Wednesday we open for extended access at 7.30am 08:00 18:30 we open at 7.15 for extended access 08:00 18:30 we open at 7.30 for extended access Not Open Not Open Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:15 13:00 14:15 18:30 Actually open at 08:20 08:45...... 12:00 pre booked appointments Not Open 18:30 19:30 Extended Hours 08:00 18:30 18:30 19:30 Extended Hours 08:00 18:30 Not Open 09:00 11:00 Extended Hours Monthly Not Open 15
Appendix Two Review of General Reported Half Day Closures Name of Contract Details Contract Type Does the practice provide alternative arrangements using a branch surgery? Details of the arrangement Has the practice given notice or informed the CCG? Are patients able to attend a pre-bookable appointment (face to face) Are patients able to book / cancel appointments Are patients able to collect/order a prescription Are patients able to access urgent appointments / advice as clinically necessary In-hours Access Arrangements for all s Reporting Half Day Closures Patient Feedback Assessment of Sub-contracting Arrangement Friends and Family Test GPPS Are patients able to Are patients able to ring Are patients able to be Are patients able to access Able to get an Overall experience Overall Patient satisfaction receive a home visit (where clinically for telephone advice referred to other services where clinically urgent urgent diagnostics and take action in relation to urgent appointment Yes responses of making an appointment experience of surgery with opening hours Very satisfied and necessary) (including for example suspected cancer) results Good responses Good responses fairly satisfied responses Is GP currently open at times when convenient? Yes responses Other Activity Data Average Assessment A&E & MIU Attendance Rate Average Assessment Higher or lower than average Weighted population rate of Higher or lower than average emergency attendances Month 11 2018 Old School House PMS No Close every Thursday afternoon. Assurance received the practice complies with reasonable access but no details of the sub-contracted arrangements are held Informed Burbage Surgery PMS No Close every Wednesday Informed afternoon. Assurance received the practice complies with reasonable access but no details of the sub-contracted arrangements are held Orchard Partnership (Spring Orchard, Fovant Surgery) GMS Yes Close on a Wednesday afternoon. Hindon Surgery GMS No Close every Tuesday afternoon. Also aware from electronic declaration analysis the practice reports to close at 5pm and phones divert to duty doctor which is the Senior Partner via his mobile. He has confirmed full access to notes Silton PMS No Close at 3pm every Informed Wednesday. No subcontracting arrangement is in place. Jubilee Field PMS No Close every Thursday Informed afternoon. No details held of the sub-contract arrangements Sixpenny Handley PMS Yes The practice have reported Not informed via electronic declaration they close every Tuesday afternoon. So no assurance received and no details held of the sub-contract arrangements. However the practice also has a branch surgery that is open on a Tuesday afternoon, to whom full access is available in this period. 97% 97% 98% 88% 88% 98% 97% 97% 93% 88% Partially informed via email. Not declared on electronic declaration Yes Yes Yes Yes Yes 96% 96% 99% 90% 87% Informed Yes Yes Yes Yes Yes 100% 99% 99% 94% 91% 99% 93% 94% 87% 84% 95% 98% 99% 92% 89% 174.44 124.22 158.39 131.94 144.72 227.92 93% 95% 94% 73% 80% 169.58 16
Appendix Three - General Core Hours Sub-contracting Assurance Template 1. Was the edec submission made by the practice in respect of its opening hours correct / accurate? YES / NO If no, provide further details 2. Is a reception accessible to patients either physically or by phone during any period of closure? i.e. own or subcontracted surgery? YES / NO If no, provide further details 3. What arrangement are in place for patients to access services (i.e. meet the reasonable needs of patients in accordance with the contract) during periods of closure within contracted hours? Free text response 4. Name and address of any subcontractor providing services Free text response 5. Address of Premises used for Service Provision Free text response 6. Distance of premises from main surgery Miles 7. What services are provided under the Sub-Contracting arrangements Free text response 17
8. Duration of Sub-Contract Years and Months 9. As part of the subcontracting arrangements, are Patients able to: a. visit the reception of the subcontracting provider b. attend a pre-bookable appointment (face to face)? YES / NO c. book / cancel appointments? YES / NO d. collect / order a prescription? YES / NO e. access urgent appointments / advice as clinically necessary? YES / NO f. request a Home visit (where clinically necessary)? YES / NO g. receive telephone advice? YES / NO h. access the alternative service locally by public transport? YES / NO i. be referred to other services where clinically urgent? YES / NO j. access urgent diagnostics and take action in relation to urgent results? YES / NO 10. When the alternative service is operating, what are the arrangements when a patient needs to speak to either a receptionist or clinician? Free text response 11. Can the sub-contractor have access to the patient s clinical record (not just the summary care record)? Please provide details. YES / NO provide details 12. What is the current average waiting time at the practice for a non urgent appointment? Number of working days (including weekends) 13. Has the practice consulted the PPG to determine whether its current opening hours and subcontracting arrangements meet the reasonable need of the patients? YES/NO Yes go to question 13 No go to question 14 18
14. How has the practice consulted with the PPG to determine whether its current opening hours and subcontracting arrangements meet the reasonable need of the patients? Free text response 15. The contract states that the Contractor must provide the services described in Part 8 (namely essential services) at such times, within core hours, as are appropriate to meet the reasonable needs of its patients, and to have in place arrangements for its patients to access such services throughout the core hours in case of emergency The contractor should therefore provide justification for not having consulted with its PPG and advise when they intend to seek their feedback Free text response 16. When did the practice last make this assessment and engage with the PPG? Month / Year 17. Do patients understand the approved / proposed arrangements? If yes provide details. responses should include how they have explained to patients how their arrangements differ from other practices providing services throughout core hours (e.g. not subcontracted) 18. Do patients have any concerns with service provision during core hours when the alternative service is operating? If yes, please provide details. YES / NO If yes provide details 19. How are patients informed of opening hours? Free text response 19
20. Please describe the demographics of the PPG and how it reflects the whole practice patient demographics and what measures has the practice taken to establish the views of particular patients groups: Free text response covering each group Patient Group Number of patient reps Measures Taken (a) Working age adults (b) Working age women (c) Children (d) Patients with learning difficulties / dementia (e) Patients with long term conditions (f) Patients with severe and enduring mental health problems (g) Patients that are housebound, dependant on home visits 21. How has the practice reflected on any trends in its GP Patient Survey results Free text response and evidence should be provided (if available) 22. What analysis has the practice (or the Commissioner for its constituent practices) done to assess patient behaviour when the practice is closed / subcontracts? Free text response and evidence should be provided 20
23. What analysis (if any) has the practice / CCG done in relation to patient flows to A&E or urgent care services when the practice is closed / subcontracts. Free text response and evidence should be provided (if available) 24. How many complaints has the practice received regarding access in 17/18 have these been upheld / partially upheld / not upheld Provide number and breakdown 25. Has the practice had any Significant events arising that could be attributed to its current pattern of opening and / or it subcontracting arrangements. If yes, what has the learning been from the SEA. Provide number and breakdown Reference Assurance of General Access and Reasonable Needs Test, NHS England, May 2018 21