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GPs go forth

Over half of GPs unable to refer to 'overflow hubs' because they are full

Overflow hubs are failing to support pressurised practices, with more than half of GPs finding hubs to be full when they try to divert patients to them.

In a Pulse survey of 650 GPs, 46% said they tried to use overflow hubs when they reached capacity, however when GPs tried to use the service, 53% found hubs to be full.

GPs said the hubs reach capacity at the same time practices do, and patients end up being passed between services without getting seen.

Overflow hubs were set up in 2016 to address extra patient needs following a recommendation from the BMA.

The appointment-only centres aim to provide additional GP or primary care health appointments for a range of practices.

But many GPs reported that they do not solve the issues of increasing demand and an overstretched workforce.

The survey found that of 649 GPs, 300 (46%) had used overflow hubs to divert patients because they reached capacity, while 289 (45%) had not, and 60 (9%) did not know.

When asked if, on attempting to do this, they found the hubs to be full, 157 of the 300 respondents (52%) said yes, 67 (22%) said no, and 76 (26%). 

BMA GP Committee member and Leicester GP Dr Grant Ingrams said: 'In Leicester we have well established hubs. We direct patients to them when we are busy/overbooked – which is mainly afternoons.

'However, when we are busy it is usual that all of general practice is busy, so hubs become full and redirect patients back to the practice.'

West Hampshire GP Dr Mat Davies, who was involved in setting up a local hub, said: 'We are a small rural 3.8 full-time equivalent practice. We have access to additional appointments at our hub and home visiting capacity from our frailty service.

'With that additional capacity last week on Monday all available appointments in our practice were full, no further appointments were available at our hub and so 11 extra patients were seen by the duty doctor on top of their usual clinical commitment. The practice also had 13 home visits that day.'

He added that his 'personal solution to the problem' is 'aiming to move abroad to practice in the next 2 years'.

BMA GP Committee chair Dr Richard Vautrey said overflow hubs, alongside evening and weekend appointments, are intended to help address growing patient need, but unless more funding follows the increasing demand, pressure will not reduce. 

He said: 'Even when this works there is only a limited number of appointments available, relative to the funding available, and the pressure on both daytime and evening services is simply a reflection on the pressure the service as whole is under, following a decade of underfunding that hasn't matched the growth in patient need.'

Last year Pulse revealed that a walk-in urgent care centre in Corby, Northamptonshire was being replaced by an appointment only GP hub. However, several months later a judge halted the plans, after the CCG failed to consult the public.



The Pulse survey was launched on 8 November 2018, collating responses using the SurveyMonkey tool. The 33 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for £300 John Lewis vouchers as an incentive to complete the survey.

Readers' comments (13)

  • Money needs to follow the patient with a fee per service. That way if demand increases, so can capacity be created.

    The fee needs to be adequate for it to work.

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  • No hubs here just the same old excessive demand grinding you down day by day.As FH says without a payment per service GP land is doomed with the grind of daily work breaking individuals down and burning them out.BMA save the NHS approach is destroying the GP workforce, destroying GP land which will mean the end of the NHS.Epic fail on the BMAs part at all levels.

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  • I've just thought of an idea. Overflow Overflow hubs.

    And then the merry-go-round (aka spiral of decline) can continue.

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  • National Hopeless Service

    We have access to two appointments per day on the other side of the county with no direct bus routes and for some strange reason the hub cant employ enough doctors so some days of the week it is closed. Darzi Centre'esk total waste of money yet again.

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  • Surely the only way overflow works is if there is unlimited access.
    So that if they are 'full' patients should just pile in and wait their turn. Then there is a sort of self-selection where those who have a minor cold can't be bothered to wait - leaving those with real medical issues a boring long wait, but at least access to a GP the same day.

    That is the only way it will work when supply is nowhere near demand. The whole point of overflow hubs is to take managing this demand AWAY from practices. If it is just about having 3 more appointments per practice, it would be far more efficient to just deliver that at the GP practice - by giving them the funding.

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  • It just makes you want to scream. I work at an “unofficial” overflow hub and I can tell you the money spent on it is a waste. It’s not too bad if the patients see me, as I make a big effort to try and wrap up care for their problem once and for all so they aren’t bounced back to the GP. Buy the other clinicians who are employed to keep costs down are useless, just delaying the time a patient ends up seeing their own GP to the next week, undoubtedly fired up with demands for all the tests and referrals that the minor illness nurse thinks they need. Perhaps I should follow my conscience back in to full time partnership but I don’t think I’d last very long....

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  • My dad would turn in his grave. What a stupid idea. Practices should only take on the number of patients they can cope with and then accept the duty to deal with them.
    Top tip. Open access turn up and wait surgeries provide a good service, make patients happy, and discourage time wasters.
    Second top tip. Continuity
    It seems that the guys in charge are determined to implement new ideas that are demonstrably inefficient.
    Are other countries doing this? No they are not. I wonder why?

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  • We need to work to reduce demand. Not increase capacity. Stop health scare stories in media and constant 'checking' of symptoms

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  • This is so NHS. The assistant to the assistant manager and so on.The excessive demands due to the media and government campaigns does not help.

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  • recent hubs I have worked at had their funding reduced so had to reduce the number of sessions they can provided, even so they can't fill all the sessions as there are not enough GP locums to fill them, the system is totally bonkers.

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