1 Oct 2013

Questions raised by the prospect of seven-day GP surgeries

Patients getting to see their family doctor in a timely and convenient fashion has long been a vexed issue, although it is not clear whether it is the patients or the politicians who are the most vexed.

Any MP or PM worth his/her salt will remember Tony Blair’s mauling in 2005 by a woman frustrated at not being able to get an appointment within 48 hours. So appointments within 48 hours were introduced even amid concerns from GPs that they were best placed to know who needed to be seen most urgently.

Britain's Health Secretary Jeremy Hunt  delivers a speech at the Evelina London Children's Hospital

This was then scrapped by the coalition government, as was the extended opening hours scheme which had resulted in 75 per cent of practices opening their doors for longer each day.

Now David Cameron has said there are to be nine pilot schemes for GP surgeries to open seven days a week from 8am to 8pm. Mr Cameron believes this will not only improve access but will also take the pressure of A&Es.

It is not entirely clear where the evidence is for this. A recent survey carried out by the Health Service Journal tellingly revealed that patients of GP practices that remained directly responsible for out-of-hours primary care may attend A&E more often than patients from other practices.  Which rather contradicts the health secretary’s assertion that the GP contract introduced in 2004 allowing practices to opt out of out-of-hours care had led to the rising demand in A&E.

And a Labour party analysis of the  2012/13 GP patient survey found that fewer than one in five patients were dissatisfied with their GP opening hours.

Parts of the media have been quoting another recent survey that said that two-thirds of patients had not been able to see their GP within two days. But that was a survey by Aviva Health UK, who sell private medical insurance.

And what the survey does not say is whether those patients had needed to see their GP urgently or whether it was something that could wait longer than 48 hours.

What has not been addressed today is the extra staff – doctors and nurses and practice managers etc – who will be needed, and what the knock-on effect will be during the week.

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