Exclusive: Fifth of GP practices drop extended opening hours amid rising pressure

A fifth of GPs have dropped an extended hours service in the past year as workload and funding pressures take their toll on primary care services, a GPonline poll has revealed.

Extended GP opening hours: practices drop services (Photo: JH Lancy)
Extended GP opening hours: practices drop services (Photo: JH Lancy)

The poll revealed the extent of the effect of rising workload on services as practices drop enhanced service work to cope with demand.

Recent BMA guidance to practices on managing workload advised GPs to consider how to drop enhanced services, particularly where they are unfunded, to relieve workload pressure. The guidance listed 33 different services the BMA considers to be additional to core general practice.

GPonline revealed earlier this year that up to 70% of GPs provide some of these services unfunded, suggesting that the profession delivers care worth hundreds of millions of pounds for free.

Unfunded GP work

GPonline’s survey asked 120 doctors earlier this year whether in the past 12 months their practice had ceased to provide any of the 33 services identified by the BMA, and why. 

Eighteen percent said they had dropped an extended hours service or contraceptive device insertions, with 15% no longer providing a smoking cessation service and 14% having dropped an alcohol and drugs misuse service.

GPC deputy chairman Dr Richard Vautrey said the survey results were 'yet another sign of the workload pressures that GPs are under and the difficult decisions they are being forced to make as they prioritise the core service they provide to their patients'.

He added: 'It's also a sign that commissioners have for too long under-priced enhanced services, with the funding provided not covering the costs of the practice delivering the service.'

GP services dropped

One GP, responding to the survey, said heavy workload had forced his practice to drop eight of the services on the BMA list in the past year.

A Midlands GP said her practice had dropped cardiovascular health checks because the ‘workload [was] too great’.

A West Yorkshire practice dropped a drugs management clinic, a GP said, because two GPs retired and there was no one left with the training to continue the service.

A London GP said his practice dropped cardiovascular checks and smoking cessation because the practice lacked the staff and funding to continue.

Other GPs said a variety of services had been dropped due to lack of funding. Others, however, said they would continue to provide unfunded services in order to meet patient expectations.

Labour extended hours

Earlier this month the Labour party obtained figures which showed 590 fewer practices in England were providing an evening and weekend extended hours enhanced service in 2013/14 compared to 2010.

The Tories said 7.5m patients could see a GP in the evenings and at weekends at 1,000 practices through the prime minister’s Challenge Fund, which is being expanded to over 1,400 additional practices, helping 10m extra people by this time next year.

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