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Independents' Day

Nine million patients told they can book evening and weekend GP appointments

Every GP-registered patient is now able to access seven-day services in London, in the largest rollout to date of evening and weekend GP appointments.

NHS England London said the two-year £26m scheme was funded from the GP Forward View, and would provide an additional 75,000 appointments every month, available to nine million patients.

Although areas across England have been piloting seven-day appointments since 2014, NHS England London said it was the first area in the country to be able to offer it to all patients.

GP practices in London are expected to signpost patients to the extended access service when open, while patients can call 111 out of hours.

NHS England's regional director for London, Professor Jane Cummings, said: 'We know it’s not always easy to find time to squeeze in an appointment with your GP to fit in with a busy work and family life.

'Appointments at evenings and weekends will not only improve access to GP services but will also help manage pressures on urgent and emergency care services especially over the busy winter period.'

But her comments come as previous evaluation by NHS England has not found a link between seven-day GP appointments and reduced pressure on urgent NHS resources.

Despite this, the Conservatives made extended access a priority in their snap election manifesto earlier this year, bringing forward from 2020 to 2019 their target for 100% of CCGs in England to provide seven-day, 8am-8pm routine GP access.

Professor Cummings said: 'Increasing access to GP services is one of the highest priorities for the NHS and I am thrilled that London is the first region to be able to offer this to everyone.

'Although patients may not see their usual doctor or nurse they can expect to receive the same excellent level of treatment and care. GPs will have access to a patient’s electronic health care record.'

Dr Sian Howell, London clinical access lead and a GP in Southwark said: 'It is fantastic that London is leading the way as the first region in the UK to offer 100% extended access to GP services...

'We need to continue to build on this to make sure we have the best systems in place across all of general practice in London, not only supporting patients to access the right service to meet their needs in a timely way, but also so those working in general practice are empowered to always deliver the best care they can.'

The news comes as Pulse revealed in June that some of the lowest take-up of Sunday appointments during the pilot phase was in areas of London, including just 2% in Wembley and 11% in Camden.

But NHS England has today launched an awareness campaign about the scheme, aiming to get patients to use the service, using the #staywellLondon hashtag.

Practices piloting seven-day working were set targets to ensure at least 60% of their appointments are used, and those falling short asked to submit plans on how they would boost demand.

GP leaders have argued that NHS England should focus on securing in-hours access, as patients are currently having to wait an average of two weeks for a routine appointment.

 

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Readers' comments (25)

  • £26,000,000 / 75,000 = £347

    Am I missing something here? Shouldn't this be 750,000 appointments, or are the time scales for the 2 numbers not aligned?

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  • The article has been updated to clarify that there will be an extra 75,000 appointments every month.

  • AlanAlmond

    I’m really pleased. Improving access for the busy working well should always be number one priority for our cash limited National Health Service. This along with immediate access to a GP for anyone with an expensive mobile phone (again in London only) is just fabulous. It’s so heartening to hear this wonderful government initiative is being rolled out in our capital city, to complement recent amazing investments in transport infrastructure. All the self important smug gits living there must be lathered up in joy. Oh how wonderful it is to be so ill you can’t take time off work and yet still get to see a Dr whenever you want to discuss your possible fungal nail infection ...sure to save to country a packet ?
    Absolutely the opposite you total and utter feckin MORONS

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  • They so love these visiting professorships:

    https://www.england.nhs.uk/author/jane-cummings/

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  • Bonkers, yet populist. Perfect for the post-expert Brexit future we are all hurtling towards.

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  • NHS England's regional director for London, Professor Jane Cummings, said: 'We know it’s not always easy to find time to squeeze in an appointment with your GP to fit in with a busy work and family life.

    That's right.......concerns regarding your health is something to fit around other priorities such as doing the weekly shop, booking your brow wax and going to the gym.

    FFS!!!!!

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  • Just an additional comment.....

    I do weekend extended hours (purely for the cash I hasten to add rather than any altruistic reasons).....it's generally full of dross.....worried well and 'you can't be too careful types'. Meanwhile Rome burns........

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  • Utterly disgraceful that NHSE is spending GPFV money on first world problems of fitting your verruca in with Christmas shopping, rather than actually stopping unsustainable practices from going under due to lack of funding.

    No doubt the government stooges will come along and tell us what a wonderful thing it is to have weekend access.

    Meanwhile Rome is in flames.....

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  • At least a 1/3 of the GP workload is clinical but not directly spent in appointments, including the horrendous amount of work being the backstop for clinical risk dumping and leakage by hospitals.
    Using the money for day time appointments also pays for clinicians to check results, follow up patients discharged from hospitals, update medications etc.
    Using this money for extended hours only gives you the extra appointments.
    The opportunity cost of this convenience if massive.

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  • Additional appointments or just redistributed (with loss of efficiency) appointments? Has the impact on out-of-hours cover been assessed? How is this a good idea given the shortage of GPs?

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  • Knowledge is Porridge

    I wonder if many of these consultations will record "MUST see usual GP within 72 hours". Most of our 111 letters finish with those helpful words. Thankfully patients ignore if they are feeling better.

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  • Healthy Cynic

    Extra resources provided to prioritise minor/trivial illness.
    Should we be looking at the bigger picture?

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  • Editor - are you sure the number is correct?

    26,000,000/75,000 x 12 (months) x 2 (years) = £14/appointment.

    If it's the right number, I'd have to applaud London's CCG for the deal

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  • David Banner

    Building another storey on a house with rotting foundations can only result in ultimate collapse. Hunt will rapidly fall from the hubris of this hollow victory to the nemesis of Primary Care in ruins.

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  • "Although patients may not see their usual doctor or nurse they can expect to receive the same excellent level of treatment and care."

    Er... No. They can't refer, follow up, they don't know you personally, might come up with plans in opposition to their own GP. The money should be spent on improving services at their own GPs.

    Jeremy Hunt says that he values the continuity that GPs provide. This contradicts that.

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  • Patients are clearly not going to receive the same ‘excellent level of care’ in a 10 minute appointment with someone who does no know them.
    Glad to know the money is being spent so wisely on evidence based healthcare rather than political motives

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  • I keep reading where ooh organisations can't fill their gp shifts or have one nurse practitioner for an entire region some nights, where did they find all the gps from?

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  • Federation working- 20 GP Surgeries get paid and only one works weekends as per rotas - How do you provide a service for the whole population? Or is this a deliberate loophole for some? We can only guess the waiting times and quality of care.

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  • Poor things: 'a busy work and family life'. Manage to fit in the hairdresser, massage, spa, gym, dentist, that necessary bit of shopping etc, etc, etc.

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  • Dear All,
    Some Professor, "Increasing access to GP services is one of the highest priorities for the NHS and I am thrilled that London is the first region to be able to offer this to everyone." Err no its not, not in this way, your own research and Pulse's proves this. But understanding that a Professor is merely someone who professes, i suppose any concept of wisdom, logic or evidence base for the content of what is being professed is indeed non essential.
    Regards
    Paul C

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  • Professors who profess usually can't hack the day job and in my experience usually have the least valid opinion.

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  • surely this will further undermine the OOH service that certainly in our area (W Sussex) struggles to find GPs willing to do the weekend shifts. This will mop up the available GPs out there and our local experience of this 'Hub' concept is that it is less cost effective than being seen in your own surgery. Probably that is the idea- to undermine independent GP surgeries and push them all into mega centres where the patient never gets that personal service they so value.

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  • It is not the “same excellent level of treatment and care”, even if they have access to the medical records. The medical records do not substitute for knowing the patient and their context. I doubt such GPs have time to read through the records anyway.
    Even if patients see different doctors in the same practice the fact that they are in the same practice and there is communication between doctors in the practice means that there is the opportunity for dialogue about patients, especially those with unusual or difficult problems, complex health needs, or who are severely or terminally ill or where there are safeguarding issues. Most practices have regular formal and informal opportunities to discuss patients if necessary. In other words, as a practice we “know” our patients in a way that a random GP in an extended access setting cannot. Furthermore the context of being in a practice means there is support and advice available and an evolved collective learning about how to practice clinically. This is lacking in the atomised isolated extended access GP model. The few of our own patients that have seen such extended access GPs have too often had care that falls below the basic standards of general practice. For example I saw a patient who had been asked to have a battery of tests, including TFTs, because he had a sore knee. The patient came to see me a little later, still with sore knee (so it didn’t save on any of our appointments), but now with the statistically predicable “abnormal result” from having unnecessary tests. Of course, he was worried about those results and reassuring him took me extra time. So the silly new “service” has actually cost me more time, while not meeting patients' needs, and making them anxious to boot.. It’s the kind of thing I teach my registrars to avoid - indeed knowing how and when to investigate and refer are amongst the competencies that GP trainees have to demonstrate to become GPs - so sad that these extended hours GPs don’t seem to practice these competencies. I suspect it’s because they are practicing defensive medicine as the circumstances are a bit scary - a patient you don’t know, whom none of your colleagues knows, whom you cannot personally follow up and will never see again - hence the over-investigation and advice to see own GP for follow up. This extended hours service is not general practice. It’s a pastiche of general practice. It is ineffective and wasteful but serves its primary purpose, which is political.

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  • Mithu Rahman

    Political obviously. No study shown so far has indicated a desire for these services NHS was never set up or 'convenience of patients'. 'Practices told to submit plans on how to boost uptake'??? How about 'there is low uptake because NOBODY WANTS IT! So how about we stop *&^%ing about and concentrate on providing the services that are actually needed?' But no, because no political capital there. Govt not interested in long term future of primary care, and that is the sad truth

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  • has anyone worked out that many areas receive London local radio stations these days?

    so whilst the radio is urging people to come in at Christmas all the surgeries will actually be shut round here

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  • Does building more roads reduce traffic congestion? Making more appointments available will only encourage more patients to book appointments for coughs & colds. The emphasis should be on preventative medicine not increasing access & and the same time reducing funding. It is clear that Hunt's brief is to make GPs fail.

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