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At the heart of general practice since 1960

Two-thirds of GP appointments 'don't need a doctor'

Only one in three people visiting a GP should be seen by a doctor, a move which could lead to practices offering 20-minute appointments, according to a think-tank. 

The report, by the Reform think-tank, found that half of patients that are currently seen by GPs could be seen by other clinical staff.

It also claimed that there was growing appetite for seven-day routine GP services – a claim disputed by GPs.

Reform said that the current model of general practice was ‘out of date’, and called for bigger practices, which it said could help stop ‘millions of unnecessary A&E visits’.

The report’s author concluded that the Government’s pledge to increase the workforce by 5,000 GPs by 2020 was ‘nothing more than a sticking plaster’.

The findings were based on a roundtable held with 22 GPs and other stakeholders.

The report said that GPs currently take around two-thirds of the 372 million appointments at GP surgeries every year – two-thirds of all appointments in practices.

Experts who were interviewed claimed that half of these can be taken on by other staff, including nurses, which they estimate would save over £700m a year and would allow GPs to offer 20 minutes appointments.

The report said: ‘General practice is out of date. The model, built for 1948, must address the ever-more complex needs of a growing, ageing and more technologically sophisticated population. It cannot do so in its current state, which affects outcomes for patients and puts significant cost pressures on the system as a whole.’

The authors praised new super-practices, arguing that the ‘quality of GP care increases in line with the size of practices’, citing CQC reports.

They also claimed that weekend routine appointments were becoming more popular, citing figures that suggested Taurus Healthcare, a federation serving 185,000 patients in Herefordshire, were filling a higher proportion of weekend appointments.

Alex Hitchcock, report co-author, said: ‘Employing 5,000 more GPs is nothing more than a sticking plaster for an out-of-date model. Bigger practices and new technology can deliver better access and stop millions of unnecessary A&E visits.’

The RCGP disputed the claims made around seven-day services.

Dr Maureen Baker, RCGP chair, said: ‘This support for seven-day general practice services flies in the face of our own research – and the fact that a number of surgeries that have piloted seven-day working have had to scale-down services due to a lack of patient demand at weekends.

‘Access to general practice services is undoubtedly important, but patients recognise that prioritising weekend and evening access must not come at the expense of access and services during normal hours. They have better things to do on a Sunday afternoon than have their ears syringed.’

The future for seven-day GP appointments

 

opening hours special report  PPL - online

opening hours special report PPL - online

opening hours special report PPL

The official evaluation of the Challenge Fund pilots released late last year supported Pulse’s evidence that there was little demand for Sunday GP appointments from patients.

But despite this, the Government has continued to push on with its manifesto plans for all patients across England to be able to book routine GP appointments every day of the week by 2020.

Pulse reported that an NHS England regional team has ploughed more money into its seven-day GP access scheme in order to ‘keep the service alive’ and fulfil the Government’s political manifesto.

GP leaders have said the Government has to focus on making general practice sustainable five days a week before spreading the service ever thinner, with a seven-day rollout costed by RCGP at £1bn extra per year.

Read more: Wheels come off PM’s seven-day GP access drive

Readers' comments (55)

  • Who is going to decide which is the 3rd one who needs seeing GP. Who will take responsibility to make sure other 2 are not going to die? Oh let the GP decide about other 2 as well and then see the 3rd one as well.
    On similar note, only 1 out of 10 A&E attendance needs seeing A&E doctor. However has any A&E clinician has guts to kick out other 9.
    And the think tank must have enjoyed numerous tea parties in hotels to come to this obvious.

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  • Soooo what they have said is all government inspired doctrine.
    Firstly, the government cannot get the gps and want patients seen by noctors etc.... so this translates to we dont need so many expensive doctor appointments and want to replace them with cheaper non-doctors. This change will make it easier to convert the system to a private one.
    Then as the government realise they cannot supply the extra 5000 gps, they need someone else to take the pressure off them by saying we do not need them any more. This conveniently goves them an excuse to ditch this promise!
    Then the 7 day nonsense again, well you know the government is behind all this as this is on their wish list as it is service on the cheap for them and will reduce the load on A and E. The fact that it makes no sense due to the lack of demand from the public again points to a government driven report.
    Spin, spin and more spin from the government's Reform thinktank which wants to reform gp service to a private one which can then be sold off. Cunning really!
    It has Jeremy's fingerprints all over it as he needs to be doing something where ever he is currently holed away hiding from the doctors whilst plotting the destruction of our profession. He cannot now even look us in the eye as he plots and schemes our destruction.

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  • They have a point. They shame is everyone is in for cash and good models get funds to innovate.
    Look at Weymouth doctors earnings in Dorset.

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  • Five years ago we took on a nurse practitioner. The GP workload fell immediately but within 3 months we were back to square one. When the nurse practitioner goes on leave the GP workload doesn't increase. All that has happened is that she just created a space for patients to consult with increasing trivia, trivia that doesnt need to be seen by anyone.

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  • Dear All
    Of course uptake of 7 day working will rise - thats pretty obvious. The issue is whether in an austere NHS we can afford, or should be affording the luxury of 7 day GP services. The money needed to provide it might be better spent on other services, especially if only 30% of these weekend appointments really need a GP........
    Regards
    Paul C

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  • Reform links to the Conservatives:

    http://socialinvestigations.blogspot.co.uk/2012/10/reform-think-tank-and-their-links-to.html

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  • Not sure I disagree with the premise - probably most don't need to see a GP. The problem is it probably requires a GP to figure that out.

    My biggest issue though is the leap from 'a broader skill mix MIGHT help' to therefore we have enough GPs and we can do 7 day working. Any evidence? Any suggestion of timeline for this to change? Any proof from another system?

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  • This is total crap.
    Firstly looking back with hindsight is not scientific-in retrospect who could have seen the patient after the diagnosis was made is different.
    Secondly there are some fantastic small practices and poor large practices around.
    This is politically driven rubbish-not a serious analysis.

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  • 8.56 WELL DONE.Instead of independent think tank should be altered to Conservative part say the above.

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  • Reform= Tory mouth piece .Analiloquy.

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