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10% of patients have no access to GPs out-of-hours

Additional access must be resourced, say lead GPs

Jo Carlowe

Tuesday, 31 July 2018

Some 10% of patients have no access to GPs outside of working hours.

The BBC’s analysis of official figures shows some five million plus people across England are unable to book an appointment with a GP in evenings and weekends.

Back in 2014, former prime minister David Cameron made a promise that everyone in England would have access to GP services seven-days a week by 2020. However, the BBC’s analysis shows:

  • 40% of patients registered with GPs - now have "seven-day 8am to 8pm" access to GPs - defined as full provision by NHS England
  • Just over half the population have access to partial provision
  • Only two areas offer full provision to GPs for all patients
  • Some 5.4 million people - or 10% of patients - had no access to GPs outside of normal working hours.
The plan has since been brought forward. From October, it will be mandatory for all Clinical Commissioning Groups to put in place arrangements for extended access to general practice.

However, the latest data - from March and collated bi-annually from surveys filled out by GPs - shows widespread regional variation.

For example, in Sefton in Merseyside, two-thirds of patients had no access to GPs outside of working hours, the highest percentage in England, while in Herefordshire every patient had access to full provision.

Responding to the BBC’s figures, Dr Krishna Kasaraneni, the British Medical Association’s GP committee executive team workforce lead, said: “While general practice continues to struggle under the intense pressures of increased demand, unmanageable workloads and a workforce crisis, these figures show that nationally the vast majority of patients have some access to GP services out of normal working hours.

“However, if the government and NHS England are to fulfil ambitious targets they must be backed up with proper resources and a concerted effort to tackle the underlying problems affecting general practice, not least the fact that there are simply not enough GPs to meet the needs of a growing population with ever more complex conditions.

“Furthermore, we know that patients are frustrated at not being able to book timely routine appointments, and it is these core services that must be prioritised for funding so doctors are able to provide the care the public expects and deserves.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, also commented. "General practice is facing intense resource and workforce pressures at the moment – our workload has increased exponentially in terms of volume and complexity, but the share of the NHS budget we receive is less than it was a decade ago, and GP numbers are actually decreasing,” she said.

"We want to give patients access to services they need, and actually the great majority of GP practices are providing extended access to their services in some form already. But we know patient demand for these services varies, and it is essential that GP practices retain the flexibility to deliver their services in the most effective way, tailored to meet local patient need - not to meet arbitrary targets whereby their considerable efforts to provide additional services come to no avail.”

She added: "With the significant workforce constraints we are currently working under, extra services might only be offered by compromising existing services – either reducing the quantity or quality of core hours offerings, or both.

"It's also essential that any additional access to services are matched with sufficient resources – and CCGs must ensure the funding to deliver extended access, where appropriate for patients, gets to GPs at the frontline of delivering these services.

"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.”

Professor Stokes-Lampard said NHS England’s GP Forward View must be delivered in full.

"The prime minister has announced additional money to fund a long-term plan for the NHS, and the vital role that general practice plays in keeping the health service safe and sustainable must be recognised in this. It is also essential that NHS England’s GP Forward View, promising £2.4bn extra a year for general practice, and 5,000 more GPs by 2020 is delivered in full and as a matter of urgency.”

Commenting, a spokesperson from the Department of Health and Social Care said: “We want everyone to have access to GP services, including routine appointments at evenings and weekends – and already millions of patients have benefitted from this which is backed by our investment of an extra £2.4 billion a year into general practice by 2021.”

An NHS England spokesperson said: “The NHS is investing at least £258m this year to offer improved access to general practice, including evening and weekend appointments. This is ahead of schedule with appointments available to more than half the country now, and they will be available across the whole country by October this year.”

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