'GPs are sitting in empty surgeries on a Sunday'
GPC chair Dr Chaand Nagpaul speaks to Joe Davis about the roll out of seven-day GP access
Given the current state of general practice – currently operating largely on limited resources, along with recruitment and retention problems – can the Government’s pledge to roll-out seven-day GP access be delivered?
I want to first scotch the myth about GPs and seven-day services because general practice does offer seven-day services, 365 days a year and it would be a total insult to several thousand GPs who will be working tonight, tomorrow night and all weekend.
What we need to do is make sure that seven-day services is supported, and currently it’s not. We know that GP out-of-hour services are woefully underfunded, and we know that many are struggling to fill their sessions, and therefore in that context the priority must be to ensure that we can deliver urgent seven-day services for those in the community who are the most ill – and that has to be our priority.
There have been reports during the seven-day GP access pilots of empty surgeries on a Sunday – but there has been some uptake of Saturday appointments. Does the GPC support the notion of Saturday appointments?
The GPC backs a move for one thing only: to use resources wisely and for it to reach where it is most needed. What we know is that urgent care and GP OOH services are woefully underfunded. Your own magazine highlighted one GP OOH provider handing back the keys because it couldn’t fill sessions. We are in an environment where GPs are at times shunning urgent care sessions in order to work instead in the same area in a Challenge Fund/Access hub seeing three patients an hour – instead of being there for acutely ill patients who may need home visits on a Sunday afternoon, that’s wrong.
So, the GP Forward View has stated that local commissioners should align access services with OOH and urgent care, and for commissioners to decide on the level of routine capacity. And in my view the right thing to do is to make sure we provide proper OOH/urgent care services, which is what patients need.
There wasn’t much mention of seven-day GP access in the GP Forward View. Why do you think that is?
I think the GP Forward View has been influenced by our lobbying. We made very clear from the outset that if the GP Forward View was an NHS England publication, which it is, it needed to learn from its own studies around the access sites which showed a lack of demand at the weekends – especially Sundays and Saturday afternoons.
We strongly argued that if this is to support general practice you can’t in the same breath putting forward political ideas that are actually going to add to our burdens.
So I think the Forward View responded to that by not being specific about 8 to 8 or seven days – what we need to ensure is that we hold NHS England to account but there is every likelihood that politicians will want to resurrect their agenda, but we need to make sure access is based around need and also in particular urgent care is what we pursue.
But are they listening to you? Because there was actually a further £500m additional investment announced in the GP Forward View to support seven-day GP access
I think unfortunately it is the politics which interferes and what need to do is keep coming back to the most important issue: is that we don’t have enough GPs or resources for five day a week working, let alone for OOH and urgent care. We have had lots of studies that have highlighted that OOH and urgent care needs more funding and had lots of publicity about that.
When politicians and the media talk about patients going to A&E rather than their GP on a Sunday, they’re not actually talking about patients having a diabetic check in A&E – they are talking about patients who have got coughs, chest infection, ear ache. All of those services are actually urgent care GP OOH services. So even politicians themselves are not being consistent with their own language – because if what they want is people to avoid going to A&E, then they need to resource GP OOH and urgent care services. It’s not going to help if GPs aren’t staff urgent care services because they are instead sitting in empty surgeries on a Sunday.
So this is about using resources sensibly and defining seven-days as being exactly around ensuring that urgent care is provided seven-day a week.