NHS data 'prove PM wrong' on GP access as nine in 10 practices open beyond core hours

Almost nine in 10 GP practices in England provide appointments outside of core opening hours, according to official data that undermine Downing Street claims that GPs are adding to pressure on hospitals by failing to provide the 'access that patients need'.

Prime minister Theresa May(Photo: Julian Dodd)
Prime minister Theresa May(Photo: Julian Dodd)

Prime minister Theresa May was widely reported over the weekend to be demanding GPs open for longer after a Downing Street source told media organisations that 'a large number of surgeries are not providing access that patients need – and that patients are suffering as a result, because they are then forced to go to A&E'.

GP leaders reacted furiously to the claims, hitting out at the government for 'scapegoating' GPs over the NHS crisis, which saw one in four hospital trusts declare a major alert in the first week of 2017.

But NHS England data published in late 2016 - the first to reveal the extent of extended access provision at GP practices across the country - contradicts claims that large numbers of practices are not offering patients the access they need.

GP access

A total of 86.3% of practices already provide pre-bookable appointments outside of core hours, covering 88.6% of registered patients, according to official data collected from 96% of GP practices in England.

The data, which practices are required to submit every six months under the 2015/16 GP contract, show that 18.5% of practices offer ‘full provision’, meaning patients have access to pre-bookable appointments on Saturdays, Sundays and on each weekday for at least 1.5 hours outside of core hours through the practice or a group of practices.

A total of 67.9% of GP practices offer partial extended access, while just 13.7% of practices are classified as having no extended hours provision.

Southampton CCG was the areas with the highest access to extended hours provision, with 96.5% of patients offered 'full provision', followed by Windsor, Ascot and Maidenhead CCG with 95% and Central Manchester with 93.8%. At the bottom of the the rankings 98 CCG areas do not offer full extended hours provision to any patients.

GPC deputy chair Dr Richard Vautrey told GPonline the data provided ‘yet more evidence of why Number 10 got it so badly wrong in trying to blame GPs for the wider NHS crisis’.

GP workload

‘GPs and their practice teams are clearly working as hard if not harder than other NHS staff in secondary care and are also under massive workload pressures. Despite that they are stepping up to do their best to offer appointments outside the already long period of core working hours. Many GPs are seeing patients before 8am or well into the evening on top of managing the huge pressures they face during the day time. It's time politicians praised and thanked GPs, rather than condemning or trying to scapegoat them.’

Dr Vautrey added that NHS England’s own evaluation of the GP Access Fund pilots showed that £45m spent delivered only £3.2m savings by reducing minor illness A&E attendances and no difference to emergency admissions.

‘This provides clear evidence that no matter how many appointments GPs are able to provide, sick patients will still need treatment in hospital and social care in the community and it's the wider cuts that have caused this wholly predictable crisis.’

Press reports on Saturday said Downing Street believes practices are failing to provide extended access, despite the government's election manifesto promise that all patients will have access to seven-day GP services by 2020.

Health ministers, however, have repeatedly made clear that the policy would not require every practice to provide extended access, which could be provided by groups of practices or hubs.

The GP Forward View published in April announced £500m of recurrent funding to be allocated to CCGs by 2020/21 to fund enhanced access schemes, building on the existing access pilots funded from the £175m prime minister’s Challenge/GP Access Fund, which launched in 2014 and now covers a third of England's population.

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