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Gold, incentives and meh

Only three areas commit to funding seven-day GP services

Exclusive Sixteen of the 19 CCG areas taking part in the first wave of the Prime Minister’s seven-day GP access pilots have not committed to fund seven-day appointments beyond April 2016.

Just two CCGs areas across the 20 first-wave pilots have committed fully to continue funding their scheme past next March, a Pulse investigation has revealed.

Another former pilot - in east London - has agreed to continue seven-day routine GP access, but only for patients with five or more long-term conditions.

And another in Bristol and south Gloucestershire has had to reapply for central Government funding.

Across the other 15 areas, two CCGs have cancelled their schemes altogether. The remainder (13) said they are still evaluating findings of the pilot schemes run over the past year or are awaiting more clarity from Number 10 regarding the future funding of seven-day access, while two have said they have no current plans for long-term funding of seven-day routine GP appointments at all.

This strikes a blow to the Government, which had always claimed that the schemes would become self-sufficient from April 2016, once savings were realised from a reduction in A&E attendances.

It comes as the Treasury has said that the £750m committed to general practice would go towards seven-day access, after Prime Minister David Cameron had originally said the budget would be £400m.

The official evaluation into the PM’s Challenge Fund pilots found that there was a 15% reduction in the number of patients attending A&E with minor ailments across the pilot areas, compared with the national average of 7%.

However, it also found that these savings amounted to £3.2m across the wave one schemes - way below the £50m invested in the Challenge Fund, the majority of which went on providing seven-day services.

The evaluation also recommended Sunday opening is ditched due to a lack of demand, with the potential of commissioning extended evening opening or Saturday morning clinics.

seven day access map 580px wide v2

The Pulse investigation revealed that NHS Hambleton, Richmondshire and Whitby CCG, and a scheme in the South West encompassing Devon, Cornwall and the Isles of Scilly have dropped Sunday access altogether and will not be funding it from April 2016.

The majority said they had not yet decided whether to continue funding it.

NHS Southwark CCG, which is one of the three that has committed to funding the services from April 2016, has commissioned 8am-8pm routine appointments on a hub basis for three years at a cost of £2m annually.

Even enthusiastic areas, such as Bury – which has been held up by the Department of Health as evidence of the scheme’s success – are unclear about whether they will pursue the scheme with a spokesperson telling Pulse the future funding of seven-day appointments was ‘uncertain’.

Dr Peter Thomas, organisational medical director for Bury GP Federation, said: ’Seven-day opening has worked very well for us in Bury. That said, discussions with commissioners are ongoing regarding the future model of extended access.’

 *This article was updated at 12:10pm, 25 November 2015, to state on the map that Southwark CCG will provide over 80,000 extra appointments a year, and not 800,000, as it previously said. 

Readers' comments (16)

  • This scheme never had any wheels. It was all up in the Air to start with. PM's PD. Pipe Dream

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  • ONE too many.
    outrageous and criminal waste of public money in context of a hugely underfunded health service now grossly failing on waiting times..and other metrics that are now causing great suffering.
    a profound disgrace from utterly ignorant totally out of touch delusional politicians.

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  • apologies.. THREE too many..but in fact even ONE is too get my anger.
    for our administration which pisses away taxpayers nhs funds in every direction in its ignorant arrogance..this is small beer for their pantechnicon of waste..sadly.
    this government deserves to be liquidated.

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  • Ivan Benett

    7 day extended hours access is being rolled out in Greater Manchester. This will benefit those who can't get an appointment during normal working hours for same day need and long term conditions. It will help to reduce those inequalities in access for people who work or have carers who work. As well as reducing A&E attendances, once the service is embedded and there is full PrimaryCare provision (not just GPs) we can start to make an impact on admissions.
    Of course this means changes in working practices and culture. It will take time, more workforce capacity and changes in skill mix. We need to work in a much more integrated way with community services to move activity out of hospital.
    In the end it's the only way to invest in Primary Care.
    Sure we need to review demand at weekends (although most cynics were saying the extra capacity would just create unlimited demand!), but once the public get to realise that at weekends the service is open they will begin to use it more. This will in turn release capacity in-hours for those who value continuity of care. Everyones a winner. It is the future, so embrace it, don't resist it, notwithstanding some of the hyperbole in these comments, and the exaggerated headlines in the magazine.

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  • Having read the latest outpouring from Dr Benett I have done everything I should do. I walked the dog, had a contemplative coffee watching the sun rise, a hot shower with some loud Mozart, and ten minutes meditation with the crossword. Yet still the most charitable thing I can say to him is this. You are wrong, very very wrong, and it's a good job I work a long way from Manchester in the twilight of my career. The Hutzpah of the man, this minority of one, who no doubt is on every Manchester GP's Christmas Card list, is astonishing. Less power to your elbow Ivan. I should imagine many younger colleagues imagine less temperate responses. Look forward to seeing you manning the braziers next week Ivan, or is the event a little "red" for you?

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  • B@llocks to extended opening.

    It will just service more undiscovered 'Want' not need.

    Just like patients already tour, A&E, OOH, after starting at walk in centres 1st, and then end up seeing me to actually sort out the problem!

    Alternatively they see me and get no antibiotics, and then trail through the other services until they find someone who has to cover their back and ends up giving it, again wasting valuable resources for the same minor ailment.

    This duplication of provision with often no actual benefit is wasting billions in a time of cuts to real services.

    Go back to need not want, and convenience is irrelevant, if unwell time off from work, is a right for all.

    Scrap the 7 day service and hire buses to ferry patients to GP appointments instead in routine hours, with extra funding to bolster in hours care, supporting those carers instead.

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  • Dear All,
    As we are all scientists i hope that Dr Ivan Benett will one day in the future report back on the degree to which his beleif's have been fulfilled. In particular the concept that adding capacity satisfies demand. As examples the introduction on NHS Direct (original ministerial announcement was to "act as alternative to ccalling out the GP"), NHS 111, MIUs, GPs fronting A/Es, GP 8x8 7/7 servces.
    Paul C

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  • Just Your Average Joe

    This ridiculous mismatch with healthcare needs and customer service style delivery assessments is politically driven disaster which the private sector are obsessed with.

    Even the private sector knows there is a limit to matching demand which outstrips costs entailed, leading to costs making extending services non-viable.

    DOH not spending own money but should still be held accountable to the public for burning essential funding for Core NHS services which are being cut.

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  • Opportunity cost.

    This whole politically led scheme is no better than handing bundles of cash to a certain section of voters.

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  • patients will turn up where the lights are on in an emergency
    Focus has to be
    self care-patients served by a website and online help signposted to SPOA triaged and worried well minor self limiting illness managed out of the system-enabling not encouraging dependence-locally owned
    1' care focussing on management of long term conditions
    Service integration so access and capacity meet demands
    managing to make the money go further is not about pandering to political ideology

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  • Dear Dr Ivan Bennett,
    would you be kind enough tell us humble GP partners
    1. what hours do you work?
    2. do you get annual/sick/study leave from your employer?
    3. who pays your subscription for Defense organisation
    4. £/hour you earn
    How many salaried GPs will be required to fill all shift for a week and the cost?
    Lastly why stop at 7 days opening? why not 24 hours GP surgeries?

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  • Can they just give him an OBE or something and then maybe he won't feel the need to post carefully worded press releases to his peers

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  • We run 2 PMCF sites in South Kent.

    The NHSE IT team refuse even to consider acess through our single smart card sign-in software to the MIG/ clincial records. Everyone here agree effective integrated care is all about access to the GP record.

    No Access = No Benefit.

    This seems to be an NHSE 'left hand not knowing what the right hand is doing' issue.

    And using a GP and receptionist for 12 hours on a sunday to see a very few patients is madness. Likewise 0800-1000h on other days. '7/7, 12 hours' is a Westminster sound-bite, not the real world.

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  • I think some extended opening makes sense. Dr Benett's post seemed somewhat more measured and, frankly, polite compared to some of the anonymous replies. The way it is being done currently can slice up current OOH providers causing chaos. But if done regularly the public could get used to this over time and it would get used. It's just too piecemeal currently and it is not coordinated with current OOH. I don't know what the full answer is, but I'm not sure blanket negativity helps.

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  • Ivan - all of my patients can make a weekday appointment. They just need to take time off work like everyone else in Europe, the Antipodes, North and South Americas etc etc. Just like I and they also have to do to see a Solicitor, Dentist etc etc.

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  • I would like to know what vested interests Ivan has in this 7 day working - how many sessions do you do clinically, and do you actually have any clue as to what grassroots GPs think?

    Stop with all of these statements and anything you say in public, please tell people that it is YOUR view only, and is not shared by the majority of the GP workforce. You dont represent me.

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