GP leaders said the findings questioned the wisdom of pressing ahead with the government's pre-election pledge to deliver seven-day GP services.
The pilots 'have been successful at providing additional GP appointment time' and access to other clinicians during extended hours, the review found. Around 400,000 extra appointments have been delivered in extended hours under the scheme, the review said, along with an extra 520,000 in core hours.
But it concluded: 'The feedback from across the wave one pilots is clear in that some extended hours slots have proved more successful than others. Whereas weekday slots have been well-utilised, patient demand for routine appointments on Sundays has been very low.
'Given reported low utilisation on Sundays in most locations, additional hours are most likely to be well utilised if provided during the week or on Saturdays (particularly Saturday mornings). Furthermore, where pilots do choose to make some appointment hours available at the weekend, evidence to date suggests that these might best be reserved for urgent care rather that prebookable slots.'
GP extended hours
The report suggests that '41-51 total extended hours per week are required per 100,000 registered population in order to meet the levels of demand experienced in these pilots'.
This suggests around three to four hours per week for a practice with an average-size list of 7,000 patients.
Of these extended hours, 30-37 hours should be GP hours, the review says.
The review adds that the Challenge Fund has increased the range of ways patients can access GPs and other primary care staff, finding that telephone GP consultations had been 'most popular and successful'.
It warns that work needs to be done to find the optimum scale for providing this service to create savings, whether a 'call centre or individual practice telephone system'.
Economies of scale
Although larger pilots have economies of scale, smaller pilots were 'quicker to mobilise and find it easier to engage and maintain exposure with both practices and patients'.
The report said £45m had been spent to date across 20 Challenge Fund pilot areas, and suggested that across a full financial year the scheme could bring a 56,000 reduction in minor A&E attendances. The financial saving was esimated at £3.2m, but this figure 'would need to be offset against the investment in primary care'.
GPC deputy chairman Dr RIchard Vautrey said: 'It's only common sense to learn from the evidence of a pilot study, particularly when the NHS has a £30bn funding gap to fill, and this clearly shows that there was little demand from patients for routine GP appointments on a Sunday or even Saturday afternoon in many areas. At £43 per consultation, no reduction in hospital admissions and only minimal changes in A&E minor injury attendances, there must be real question marks about the wisdom of carrying on with these schemes.
'When practices are having to cope with as little as £140 per patient for a whole year of comprehensive primary care there is an urgent need to redirect the millions of pounds being spent on this politically motivated project to properly fund both the daily services of GP practices and the under pressure 24/7 GP urgent care service.'
Speaking exclusively to GPonline earlier this year, health minister Alistair Burt said the government would not press ahead with seven-day GP services in areas where there was no demand.
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