Dr Chris Mimnagh: The yin and yang of GP access

Reporting availability of GP appointments will be fraught with difficulties as practices have all developed their own systems to meet demand, says Dr Chris Mimnagh.

Yin and yang are wonderful concepts, the balance and harmony of life.

I couldn't help think about them when two stories trotted out last week. The first, from the Budget, about stationing GPs to work in emergency departments made me yawn. It's been done. When it's done well it's great, when it's done badly it's useless. So local solutions will produce local results, there you go, remember this in a couple of years when the evaluation comes in.

The yang to that yin is the idea of reporting GP appointment availability, which NHS England revealed.

When I was a PCT medical director we had to report the same data and routine appointment availability. The method back then was to contact the practice and ask when their next appointments were.

Amazingly all practices offered same-day slots for urgent care and within 48 hours for routine appointments. Unbelievable, you say, well this was the late noughties, and sometimes people were naughty.

This time round I bet we'll have a quick data extraction exercise which will pull out the relevant data. I wouldn't suggest that the stainless steel rats of general practice (and that's a compliment) will always keep a couple of slots free on EMIS to defeat such a technique, not least because demonstrating difficulty or problems with access might (don't quote me) end up in investment.

It's a risky strategy and one my practice can't offer as we're nearly three years into a new model of practice – nothing special, nothing unique, just helping us get by on phone-based assessment. But we all have customised our appointment systems in many ways, so automatic reporting will be fraught with challenges.

Tell you what, I'll go and work in A&E until things get sorted...

  • Dr Chris Mimnagh is a GP in Liverpool and head of clinical innovation liaison and deployment at The Innovation Agency, the academic health science network for the north-west coast.

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