GPs must keep up with access demands, warns advice charity

Fragmentation of services, funding cuts and the GP recruitment crisis are to blame for young adults turning to A&E when they cannot access primary care appointments, GP leaders have warned.

Waiting room: young patients unable to access appointments (Photo: JH Lancy)

An analysis of the NHS GP patient survey by the Citizen's Advice charity concluded that young people were more likely than older patients to go to A&E when they cannot get a GP appointment, and called for GP practices to make it easier for young people to access general practice.

The report found that:

  • One in seven people (14%) aged 18-34 were unable to see a GP last time they tried to make an appointment. One in eight of these went to A&E instead.
  • Just one in 17 people (6%) aged 55 or over said they were unable to see a GP last time they tried to make an appointment, and one in 17 of these went to A&E instead.
  • One in eight (13%) younger adults did not get any professional help for a health problem when they were unable to see their GP.

Citizens’ Advice chief executive Gillian Guy said GP services must keep up with modern lifestyles. ‘Long working hours means it can be difficult for younger adults to get an appointment with a GP, let alone one at a convenient time. As a result some people are struggling to access the medical advice they need,' she said.

Busy working lives

'It is in the NHS’ interest to get primary healthcare for younger adults right and ensure services fit around busy working lives. A failure to meet their needs piles more pressure on budgets and is an inefficient use of scarce NHS resources.

She added: 'Many GPs are already transforming the way they provide services and embracing new technologies. It is vital that they keep up with how people of all ages want to engage with public services including healthcare.'

The report called for GPs and CCGs to support new powers to register out of area patients which are due to come into effect on 5 January 2015.

GP leaders have criticised the scheme warning it could cause funding problems and warned practices to consider whether the remuneration was enough to cover their costs.

Meeting expectations

A primary care service which reflected the needs and expectations of young people’s needs, the Citizen’s Advice report said, would include online/appointment booking, greater walk-in opportunities, more accessible health services in the community, improved access where people work or study, and more flexible appointment times.

GPC deputy chairman Dr Richard Vautrey said: ‘GPs provide a 24/7 service with most surgeries not only working increasingly hard during the day to cope with rapidly rising demand, and many offering extended opening hours providing early morning, evening and weekend appointments, but in addition large numbers of GPs work for out-of-hours organisations seeing patients right through the night.

However, both day-time and out-of-hours services have seen funding cut, and are increasingly struggling to recruit new GPs, at the same time as demand for appointments has been increasing. The problems with NHS 111 and the confusing fragmentation of urgent care services have also made things worse rather than better.

Rising demand

‘With demand for appointments rising and more care being delivered in the community, the system is struggling to keep up. We desperately need more GPs and investment in services if general practice can deliver the care patients need, when they need it and keep up with the sheer number of patients coming through the door.’

The government and NHS England have committed £100m to extending the prime minister’s Challenge Fund to improve GP access. Pilot programmes are already benefiting 5m patients, according to NHS England.

The Conservatives have pledged a further £400m over the next five years to widen access to general practice in evenings and at weekends across the whole country.

Labour has pledged £100m to guarantee every patient will get a GP appointment within 48 hours.

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