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GPs meeting 48-hour target are criticised for restricting access

GPs meeting the Government's 48-hour access target have been criticised by the Commission for Health Improvement for running appointment systems that restrict patient access.

A CHI report into Doncaster East and Doncaster Central PCTs, where almost all practices are hitting the target, found patients were not able to prebook appointments at many surgeries or had problems getting same-day slots.

Most practices in the two trusts are attempting to run the advanced access appointment system in order to provide 48-hour GP access.

CHI's findings come after the Government attacked practices for failing to offer advance appointments. Health Secretary John Reid said last year patients 'were entitled to expect' to be able to prebook.

But many GPs complained they could not offer 48-hour access using advanced access and provide prebooked appointments.

In its report on Doncaster East PCT, where all practices are providing 48-hour access, CHI said getting patients to telephone for same-day appointments had caused 'difficulties' for patients and staff.

It added: 'Both told CHI of difficulties with this new system, including large queues at some surgeries, not being able to prebook and difficulties in contacting the surgery by telephone.'

Some surgeries in the trust were only offering same-day appointments, CHI found.

Lorraine Wilkinson, practice manager at the Rossington Practice, said the surgery found it difficult to run advanced access as it has a longstanding GP vacancy. 'We struggle with the appointments', she said.

CHI reported similar findings in Doncaster Central PCT.

Professional executive committee chair at the trust, Dr Alastair Graves, said it recognised the advanced access system 'is not perfect'. He added: 'Practices are encouraged to review their processes and learn from those achieving their targets.'

Doncaster East PCT chief executive Jayne Brown said it was running an online repeat prescription service, flu vaccination clinics and nurse triage to help tackle access problems.

Ruth Kennedy, chief executive of the National Primary Care Development Team, which promotes advanced access, said practices not offering prebooked appointments were 'not being respectful of the needs of the patient'.

She added the system is designed to help practices with vacancies. 'It's about managing capacity,' she added.

Running advanced access successfully

National Primary Care Development Team advice on running an effective advanced access system:

 · Keep patients informed that the system is in place

 · Offer patients alternatives to face-to-face consultations, such as telephone or online consultations

 · Develop plans for unpredictable events such as a flu epidemic

 · Constantly measure demand at different times during the week

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