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CAMHS won't see you now

Patients prioritise weekday access over seven-day opening

Most patients would prefer their GP practice to offer extended hours for weekday appointments rather than weekend opening, a new study has found.

The study of 1,700 patients registered with general practices in England found that around half of patients said the main factor deciding their choice of practice was weekday access.

The findings come as the Government is pushing for practices to provide seven-day access, with Prime Minister David Cameron setting up a £100m fund committed to delivering seven-day GP access, following a similar £50m fund.

A team of health policy researchers from the London School of Hygiene and Tropical Medicine asked the patients to indicate whether they would register with a local practice or one outside their neighbourhood, depending on various factors such as whether they offered Saturday and Sunday opening times and extended opening hours on weekdays, how quickly patients could get to see a GP and how well the GP knew their specific needs.

For around half the patients, termed ‘convenience shoppers’, the key factors that drove their choice of practice were extended weekday appointments and how quickly they would see the GP.

The results also showed most patients did not care about weekend appointments when choosing a practice, according to the authors.

The team concluded: ‘There is little evidence that the English population will be more satisfied with weekend opening of GP practices, while extended hours during the week and increasing the proportion of patients able to see a GP on the same day are more likely to meet the population’s preferences.’

Health Policy 2014; available online 22 Oct

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  • GP surgery reception

Readers' comments (12)

  • Ivan Benett

    These findings are consistent with our general findings that extended hours is met very favourably by the public that have accessed them. About 20-25% say they would have attended A&E if these appointments were not available. These figures are from a patient survey of about 200 people. If this refflects the whole population of people attending extended hours (over 7,000 patients), this means a large number of people. It is roughly consistent with the fewer number of people attending A&E this year for the Primary care stream, than the previous year.
    In addition there is a 50% reduction in people attending A&E who say they 'can't get an appointment at the GP'
    However, weekend attendance has been less keenly taken up. Saturdays get filled, but as yet Sunday surgeries often have unused capacity.
    When I think back at Sunday retail opening, I do remember not wishing to use shops on Sundays, but now I know they are open and find it difficult to shop during the week, I often go shopping on Sundays.
    I know lots of readers will blow a fuse at the suggestion that attending a GP is like shopping, but actually, it is.
    There, send you angry anonymous comments, or if you want a sensible discussion then email ivan.benett@nhs.net

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  • Ivan, this isn't an angry comment, but the difference between seeing your doctor and shopping is continuity of care. When shopping it is continuity of the brand you want, and this is the same whenever the shop is open. With a doctor you want the person that you know. This will always be what is sacrificed with 7/7 opening.

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  • Another difference is you shop only if you pay for it and can afford it. Offering 24/7 health care for £3 per week is ridiculous - its like an "eat all you want" buffet that is being forced on the provider for round the clock access.

    Supermarkets are open 24/7 because more customers=more profits - for those of us in General practice, the reverse is true. .

    Fee for service, perhaps, as per New Zealand/Australia, with ramped payments for weekend/evenings, and even higher for convenience home visits. Until then, for £2-3 per week payment the average GP gets per patient, they can eat all they want 0800-1830, and the buffet choice is getting smaller.

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  • Vinci Ho

    Bee Gees released a song on 21/12/1968.
    Robin Gibb's son played the song on his phone after his father died in 2012.
    Long Live Bee Gees

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  • My local surgery has the following charges

    Fees
    Under 6 yrs Free
    6-14 yrs $35.50
    15-24 yrs $45.80
    25-44 yrs $56.00
    45-64 yrs $56.00
    65+ yrs $53.00

    These charges are for a standard 15min appt which is state subsidised. Go over that and you pay full rate which is nearly double for the next 15mins. Evening appts cost $20 more. They are open on Saturday and Sunday morning for walk-in appts at a further $20 on top.

    Anyone who thinks this can be done for free is bonkers.

    Oh and the surgery has had two new Drs from England, the last one in the last 3 months.

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  • Harry Longman

    Continuity - that's the thing. Not everyone needs or wants it - true. But the most vulnerable and needy, nearly half, do need it. And here's the maths:
    http://gpaccess.uk/evidence/continuity-myths-maths/
    Routine weekend opening will destroy it. Weekends need to be emergency primary care only.

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  • Ivan rather proves the point that causes many of us concern. He didn't have any desire for Sunday shopping until it was available. After a while, additional opening becomes taken for granted and then a reduction would be resisted. The same might be applied to GP opening with the rather crucial difference that what might be funded to promote demand will soon become a "right" with no guarantee that the funding will continue (and every possibility that it won't). Do private GPs hold routine surgeries at weekends?

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  • The sad thing is that THIS is the research which will be consistently ignored by the government and not used by our leaders to fight our corner. Not going to be the headline in the Daily wail. Agree with the person who has rates patient pay for convenience.
    And thanks Ivan for your ever useful comments. Enjoy working Sunday, we'll see how you get to the shops then. The rest of us have a family and life we would like to see and use while we can.

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  • Ivan compares General Practice to shopping at Tescos.

    How about we look at some of the fundamental flaws in the comparison?

    GPs not a price per visit. Increasing demand leads to same money.
    GPs take 10 years to train, tescos staff do not
    Practices do not have the space to enable 24/7 rota (never mind staff)

    Maybe if we start charging for GP consultations?

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  • Dear Ivan, If you are so obsessed about availability of GPs why is your practice closed on Weds afternoons and have you read any of your NHS Choices comments about availability? I am surprised your CCG havent had a go at you about it .......oooops you are the CCG Clinical Director.

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  • In my town we have seven supermarkets open daily, but only Tescos is open 24hrs. Everyone shops where they prefer: the vast majority using the smaller, more personal, comfortable service of the brand they know, seeking their own continuity. But in the middle of the night, when you discover you need something urgently, or you have got home from work too late to visit your usual supermarket and you need dinner tonight, we have all used Tescos 24hr service.
    What we need to recognise is that Primary Care is just that, not Emergency Care. No 24/7 or even 12/7 primary care service is going to be able to deliver the same level of care, continuity and professionalism as our patients deserve and expect. What this research is telling us is that patients acknowledge that too. They would like evening surgeries so they can attend without their children, or after work, or bring their aging relative to understand better their needs, and an hour or two of evening surgery a couple of times a week is reasonable to expect, but otherwise, Tescos is open and willing to serve.

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  • the comparisons with supermarket and shopping are silly.
    if we were charging for the visit then comparison becomes real.
    Tesco---everytime you visit and buy something they earn.
    GP everytime you visit or get service ---it is free.
    Tesco will have warehouse attached to it
    GP service dont have even basic investigating services attached to it.
    Tesco is big and has many workers.
    GP services are small and dont have too many people working in it.
    Tesco is more like hospitals
    GP are more like isolated corner shops apart from corner shop profit from opening longer and 7 days a week GP services wont do that. also corner shop dont need to update the man behind the desk to keep uptodate otherwise serious harm to customer, gp services --man behind the desk needs to update himself constantly.
    if you dont like tesco or any other supermarket you can go to another.
    gp services give that provision and continuity goes down the drain, and that is what everyone is fighting for.
    even though continuity is a buzz word for everyone but actually seeing different people might be more useful as new set of eyes can see things froma different perspective.
    anyway supermarket like tesco are also going at a loss.
    there is no comparison between shopping and health otherwise make shop assistant sit in a surgery and let them do the job./
    main problem is less no of AED's and staff cuts in the past we need more GP's, AED Drs, Hospital specialist, nurses and health care workers to give a first world health care experience to the first worl country rather than due to money constraints and political diktat and interference give a third world experience to first world residents

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