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More GPs needed to make flexible practice a reality

Advent of 24/7 GP service ‘misleading’

Jo Carlowe

Tuesday, 01 October 2013

The Prime Minister’s announcement of more flexible GP working requires proper investment in primary care, say senior doctors.

Responding to the government proposals to pilot extended GP practice opening hours, doctors' leaders say the scheme can only work with extra GPs and properly funded support services.

Moreover, lead-GPs say the public is being misled to believe they are being offered a more comprehensive service when in fact, the proposals set out a co-operative style of working - something that has been around for decades.

Prime Minister, David Cameron made his announcement for plans to extend GP hours from 8am to 8pm seven days a week, on the penultimate day of the Conservative Party’s annual conference in Manchester.

Under the scheme, to be piloted in nine areas in England, practices can apply to a £50m Challenge Fund, to offer extended GP hours from 8am to 8pm seven days a week and to make greater use of modern technology to offer consultations via Skype and email as well as phone. The scheme also includes the ‘joining-up of urgent care and out-of-hours care to ensure rapid walk-in access’.

The first wave of ‘pioneers’ will form part of a wider plan ‘to strengthen out-of-hospital NHS care, and make it easier for practices to join up with each other, as well as other services provided in the community,’ the government states.

Ministers want to use the pilots as the first step to rolling the scheme out across the country.

Health Secretary, Jeremy Hunt, said the proposal fitted with modern living.

“We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people,” he said.

And Professor Steve Field, Chief Inspector for General Practice, called on GPs to embrace the move towards seven day services.

“I want to see brilliant access to GP services for patients across the country, and will be assessing this in each practice I inspect,” he said.

But Dr Chaand Nagpaul (pictured), chair of the BMA’s GP Committee, said the proposal needed to be underpinned with additional resources.

“Crucially, for this to work the government needs to address issues around GP numbers and support services,” he said.

“Without extra GPs the existing workforce will have to be stretched over seven days, meaning potentially reduced services during the week. It will also require additional resources and investment in support and diagnostic staff such as district nurses and access to community care so GPs can meaningfully provide a full service across the week, and it remains to be seen if the money set aside will be enough to deliver this.”

Speaking to OnMedica GPC deputy chair Dr Richard Vautrey said it was important ‘not to kid the public that they are expanding the existing service’. He urged people to ‘read between the headlines’ noting that the proposal pointed to a more cooperative type of service - something that GPs had been offering for the last 20 years.

Royal College of General Practitioners Chair Dr Clare Gerada called the £50 million Challenge Fund ‘a small first step towards redressing the massive under-investment’ in general practice.

However, she added: “It is crucial that as much of this as possible is ploughed into frontline general practice so that patients will benefit directly.

“GPs are keen to do more for their patients - with many already working 8-8 and at weekends - but we are heaving under the pressure of ever increasing workloads and diminishing resources, including a chronic shortfall of GPs.

“General practice currently counts for 90% of patient contacts within the NHS yet receives only 9% of the budget. Some of us are routinely working 11 hour days with up to 60 patient contacts in a single day and we cannot do more without the funding and resources to back it up.”

And she added that in a recent RCGP survey nearly half (47%) of GPs had been forced to cut services for patients due to lack of resources.

She concluded: “We now need the Government to go much further and give general practice its fair share of the NHS budget so that GPs can deliver more care and better access to services for their patients in the community.”

The first wave in the pilot will open during 2014/15.

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