By Mark Fairlie
Data analysis by the BBC shows that over 5 million people living in the UK can’t book a GP appointment outside working hours.
Across England, 10% of registered patients live in areas where they can’t access GPs at weekends or evenings. And while NHS England claimed that everyone will have access to extended care by the 1st of October, Labour has blamed the government of “breaking promises”.
The facts and figures
Official data analysed and collected by the BBC shows that only 40% of patients registered with GPs can book an appointment on weekends and evenings.
NHS England defines seven-day 8am to 8pm access to GPs as “full provision”. The data found more than 22 million people have full provision however only two areas in England offer it to all patients
Parietal provision is when a GP practise offers the minimum of ninety minutes of bookable appointments each week. Over half of England’s population have access to parietal provision.
10% of the population have no access to GPs outside of normal working hours. This figure translates into 5.4 million patients unable to book appointments on evenings or weekends.
England’s former Prime Minister David Cameron promised that by 2020 the entire population would have full access to GP services seven days a week. However, these plans have been brought forward to October.
From the 1st of October, all Clinical Commissioning Groups must create arrangements for extended access to general practise as this will be mandatory.
The widespread regional variation came to light when data, published in March and supplied by GPs on a bi-annual basis, was analysed.
For example, two thirds of patients have no access to GPs in the evening or weekends in Sefton in Merseyside. Patients in Merseyside have the highest percentage in England for their lack of GP access outside working hours.
In comparison, Rushcliffe in Nottinghamshire and Herefordshire have the highest percentage of full provision as every registered patient has access to GPs in evenings and weekends.
Extended access to general practise is not compulsory, according to a spokesman for NHS South Sefton CCG. Instead, they said extended access to general practices was “undertaking a procurement exercise” to offer services from October.
An NHS spokesman for Rushcliffe CCG stated that “vanguard funding” had allowed them to offer full provision to their patients.
The NHS created and funded vanguard sites and, in 2015, NHS Rushcliffe CCG joined the scheme, becoming one of fifty sites. The NHS created these sites to bring community services, hospitals, GPs and care homes together to offer extended care.
NHS Herefordshire CCG also offers full provision with the help of the GP Access Fund which was originally called the Prime Minister’s Challenge Fund.
In 2015 NHS Herefordshire CCG became one of twenty-one pilot areas funded to extend GP hours. Through the GP Access Fund, it has been able to commission a GP Federation to offer three hub sites that provide seven-day a week service across England.
GPs had been previously advised to offer seven-day services or risk losing funding.
The problem with Hubs
Christine Price is from Healthwatch Herefordshire which describes itself as the independent champion for people who use health services in the county. Price said that while everyone wants convenience of care, getting services to those living in rural communities is a problem.
She went on to say that
“(p)eople thought their own local GP would be open as part of extended access, but it’s not realistic with twenty-four practices across the whole county.
“With limited transport between market towns and rural areas, the reality is not everyone can access services.
“If all patients wanted to use it, it wouldn’t have the capacity for them to use it.
“People without money, friends and family nearby struggle to access services outside of their immediate area. It’s not there for everyone in reality.”
The debate over funding
The government’s priority to extend patients access to GPs has been criticised by doctors’ groups. They have suggested that the critical shortage of GPs should be addressed before trying to provide the whole of England with extended GP hours.
Dr Richard Vautery is the British Medial Association’s (BMA) paper GP committee chair. In the BMA’s most recent paper on the subject, Dr Vautery called for the government to address “increased demand and unmanageable GP workloads”.