Dr Chris Mimnagh: Why seven-day opening is not the best use of GPs' time

'Measuring a fish by its ability to climb trees creates an unhappy fish' is something I've heard teachers say when talking about assessments.

That phrase popped in to my head with the finding that a third of practices are offering Sunday opening and the Conservative manifesto promise to deliver seven-day GP access for all patients.

As you know I am a change junkie - it's the only constant in life. But, that said, I'm hesitant to embrace 7/7 opening as a key feature of general practice. I hesitate because what we do so often defines who we are as medics.

We often say we are general practitioners, not that we practice generalism. If we are seen and understood to be the seven-day service ‘just like the good old days’ then we will be perceived as the alternate to the 24/7 emergency department, something our current paymasters would delight in achieving.

However, I'm not sure that general practice being seen as an alternative to walk-in centres or packed emergency departments is actually sensible. Marketing the value of highly-skilled solvers of complex human problems as a convenience store will not deliver a sustainable model of care.

Our skills reside in solving the problems that self care and walk-in centres can not. But those problems are complex, lengthy evolutions which, if we are not spread thinly over seven days offering access to small children with self-limiting illnesses, we will be able to deliver in a five-day service. 

That's what the NHS needs for the next twenty years, that's the future, that's general practice.

  • Dr Chris Mimnagh is a GP in Liverpool.

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