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Study reveals quarter of evening and weekend GP appointments unused

BMA and RCGP say drive for seven-day access wasteful and unnecessary

Mark Gould

Monday, 01 October 2018

NHS England plans to extend GP access have been come under fire from the BMA and the Royal College of GPs as an investigation reveals around 25% of evening and weekend appointments are being left unfilled.

Evening and weekend appointments have been gradually introduced since 2014, on the basis of a Conservative Party pledge which is now promising every patient will be able to book a routine appointment any day or evening by March next year. Under NHS guidance from earlier this year, today was set as a date by which all Clinical Commissioning Groups (CCGs) were required to provide extended access to GP services.

However, a Freedom of Information (FoI) request by GP magazine Pulse reveals that around half a million appointment slots have been left empty on evenings and weekends.

The FoI, which was answered in full by 80 CCGs already operating extended access schemes, shows take-up remains lowest on Sundays, when 37% of appointments go unfilled, followed by Saturdays at 24%. On weekday evenings, 23% of slots go unused.

Pulse estimates at least £15m has been wasted on the total of 501,396 unused extended hours slots across the 80 CCGs that responded to the FoI. This is based on NHS England’s evaluation of the scheme’s pilot, in which the cost of each appointment was around £30-50.

In response, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "At a time when general practice is struggling for resources, and patients are waiting longer and longer for appointments, to find out so many evening and weekend appointments have been unfilled due to lack of demand is shocking.”

Prof Stokes-Lampard said GP practices know who their patients are, so they are best placed to make decisions about how to provide extended access to routine services in the best interests of their local population, and not simply to meet arbitrary targets.

"Patients should already be able to access GP care when they need to through routine GP services and the GP out-of-hours service. What we need is better public awareness of the different services available for patients, so that they know where to turn when they become ill,” she added.

And BMA GP Committee chair Dr Richard Vautrey said: "Because it has become a political must-do, everybody is jumping. We understand there is huge pressure from the centre on CCGs to demonstrate they are providing a full seven-day service.

"Sensible CCGs that want to use their resources in a better way are under pressure to maintain a service that really isn’t good value for money.

"That is ridiculous so I think we really do need to see much more common sense and pragmatic flexibility… if we had the luxury of resource and workforce then we could look at extending the service but until then we’ve got to focus on what is most important."

An NHS England spokesperson said: “Even though six out of 10 CCGs didn’t respond to this small survey, the more representative results of the annual GP survey and the patient response to new digital-first GP providers is clear: patients want quicker access to a trusted GP both during the working week and outside traditional surgery hours, and are increasingly prepared to vote with their feet to get it.”

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