GPs are always willing to look at ways they can improve patient care and we realise that opening hours are an important issue for many members of the public. However, for this proposal to work the government needs to work with clinicians to address the current issues around GP numbers and support services.
GP opening hours are not a ‘one size fits all’ issue; while commuters in cities like Manchester and London may prefer evening appointments, the older demographic in areas like Bournemouth and Eastbourne rely on GP access during the day. This shows why GP practices need to have flexibility in order to offer their patients the care they require, and why some practices already provide extended opening hours.
The increased demands of an ageing population combined with other pressures means that GPs are already seeing more people than ever before and in many areas services are badly overstretched. GP practices are also struggling with declining funding, new targets and increased bureaucracy that is reducing the number of appointments available to the majority of patients.
Given this environment, if there is a move to substantially increase GP opening hours across the board we will need to address how we are going to deliver this. In particular, we will need to consider the impact on the existing workforce, including support staff, and current resources, which are already struggling to meet current demand.
This week, health secretary Jeremy Hunt said he wants and hopes history will judge him 'to be one of the most pro-GP health secretaries’. This is a noble ambition, but if he is to achieve it he needs to work with the BMA, GPs and patients to ensure we have the practical means to deliver what is best for the public. We need a flexible, well resourced service that is not burdened by unnecessary targets and cumbersome bureaucracy.
And yet the question remains - how do the politicians who call for a fully functioning 24/7 NHS expect to resource it when the government can hardly afford its current model, and when demands are being made to take out a further £20bn from the NHS budget by 2015 as part of the Nicholson challenge?
These measures will only fuel the demand culture, and fail to take into account the available resources, investment required, and flexibility that will be needed to achieve this.
I will be watching to see how the proposed pilots will work and I am committed to working with the government to improve access to care for our patients – the people who really matter.