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GPs defy ministers' orders to offer pre-booked slots

GPs running advanced access and same-day appointment systems are defying Government demands to offer pre-booked slots.

Practices protested they cannot offer both types of appointment and satisfy increasing PCO pressure to hit the 48-hour access target unless they get extra staff to meet the additional workload.

The Department of Health last month threatened action against GPs who refuse to offer pre-booked appointments or limit the number available after growing patient complaints.

The National Primary Care Development Team, which promotes advanced access, has also informed practices running the system they must offer booked appointments.

Dr Graham Busfield, a GP in Swallowfield, Berkshire, said his practice was trying to move towards 48-hour access but could not also meet demand for pre-booked appointments with its present staffing.

He said: 'I can't see that same-day access fits with the need for long-term care of chronic conditions as we are losing the opportunity to say "I'll see you in three weeks".'

Dr John Reid, a GP in Selby, East Yorkshire, said it was 'inevitable' access targets would be missed if practices had to offer a high proportion of advance appointments.

He said his practice was now offering pre-bookable slots up to five days ahead but was concerned it would stop hitting the 48-hour target and face a dramatic increase in workload.

'I have major concerns we are causing ourselves to move backwards,' he added. 'If you start pre-booking appointments patients are good at getting their own way. It's easier if staff can say ''no'' rather than ''maybe''.'

Dr Sir John Oldham, head of the development team, admitted practices that were under-staffed would have to work harder to offer both types of appointment but insisted advanced access gives GPs 'more scope to cope with changes in demand and capacity'.

He said he would be disappointed if practices 'felt under duress from PCTs' to adopt the system to hit access targets.

'It's intended to be voluntary,' he added.

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