Seven-day GP plans imposed 'without understanding demand or capacity', warns NAO

Plans to roll out seven-day GP services across England by 2020 are being implemented without the necessary data to understand demand or capacity of the existing service, the National Audit Office (NAO) has said.

Patients are waiting longer to get an appointment

In a ‘stocktake’ of access to general practice published on Friday, the independent parliamentary auditor said there were ‘significant gaps’ in the data available on GP services, particularly on numbers and types of consultations. Better data, the report said, would help workforce planning and demand management.

The report also called on NHS England to research how different appointment booking systems and other arrangements drive variations in access.

Commissioners, the NAO said, should try to influence patient behaviour to reduce demand on GPs and make more use of alternatives.

Patient satisfaction

The study said that while people’s experience of accessing general practice remained positive, with around 90% of patients able to get an appointment when they last tried, satisfaction was gradually but consistently declining.

Auditor general and head of the NAO Amyas Morse said: ‘Against the background of increasing demand and pressure on NHS resources, the challenge is how to maintain people’s positive experience of accessing general practice and reduce variation. The DH and NHS England are working to improve access, but are making decisions without fully understanding either the demand for services or the capacity of the current system.

‘Better data is needed so that decisions about how to use limited resources to best effect are well-informed.’

RCGP chairwoman Dr Maureen Baker said the high satisfaction rate was testament to the hard work and dedication of GPs.

GP workload

‘But it cannot be ignored that as general practice strives to meet the increasing demand of a growing and ageing population, with consistently fewer resources, our patients’ ability to make a timely appointment is worsening. Recent analysis by the college based on the latest GP Patient Survey found that on 67m occasions this year, patients will wait more than a week for an appointment with their GP or nurse.

‘This is most worrying because when a patient can’t make an appointment with their GP, we don’t know where they go - they might get better on their own, they might visit A&E where care is far more expensive, or they may simply stay sick. It is also concerning that where people live is affecting their ability to access general practice services – something that should never be the case.

Dr Baker added: ‘Our patients should always be able to see a GP when they need to through the existing five-day service and existing GP out-of-hours service – instead of looking into extending routine GP access, the first priority of politicians and decision makers should be to concentrate on making these services more accessible and better integrated.’

An NHS England spokesman said: ‘Real terms spending on general practice has increased every year since NHS England was established, following two years of decline, and the vast majority of patients have reported a positive experience when accessing general practice. ‘This year we are investing an extra £126m to improve access to  general practice as well as working closely with our partners to expand the primary care workforce and further benefit patients.’

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