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CAMHS won't see you now

Thousands of patients flock to pilots of GP weekend opening

Around 7,000 patients have accessed GP services at the weekend in the first 11 weeks of one CCG’s groundbreaking trial, prompting GP commissioners to hail it as a success as NHS England prepares to unveil further details of national pilots.

The scheme, which cost North Durham CCG £1.2m of ‘winter money’ and is aimed at reducing pressure on emergency services, could be extended beyond its 31 March cut-off date, while in another pilot of seven-day opening in Manchester, one practice has seen 90 patients per weekend in the first two weeks of the trial.

The first statistics from the new pilots of weekend opening come as NHS England prepares to publish details of how GPs across the country can apply for a share of a £50m fund announced by Prime Minister David Cameron in October to allow nine areas to trial expanded seven-day access.

Board papers published by NHS England said: ‘NHS England will commission pilots across England during 2014/15 to set up improved access to general practice for at least 500,000 people; and [e]valuate these pilots to identify the most effective ways to improve access to routine primary care – and support a more a integrated approach to urgent care services – in 2015/16.’

GP leaders have previously criticised the Government’s plans for seven-day opening because of the extra funding it would require.

But unveiling the first statistics from its scheme, North Durham CCG said 7,000 patients had been seen on Saturdays since 1 October, including 800 referred via 111.

Dr Neil O’Brien, chief clinical officer at North Durham CCG, said there was ‘definitely a need for the scheme’.

As part of the trial, practices are offering pre-booked appointments to patients on Saturday as well as operating an alternative service taking referrals from emergency services where appropriate.

This includes patients being diverted from A&E, as well as patients being referred for an appointment after calling 111. Nurses are also on site to offer services like flu jabs at weekends.

A Pulse analysis of year-on-year hospital statistics from the area found that total A&E attendances were down 9% for the first week of December, although this covered the whole of the County Durham, Darlington and NHS Foundation Trust area, not just North Durham.

The CCG said it lacked reliable statistics on the number of patients diverted from A&E to date. However, it added that this option had been underused due to an IT issue that meant A&E staff could not access GP appointments systems and which had now been corrected.

Dr O’Brien said: ‘You want patients to come through 111 and not actually clog up the A&E. There have been some diversions from A&E but we had some initial problems with the software to get them booked in with the practices. That has now been resolved so that should increase over the next few weeks.’

Dr O’Brien said he ‘would like to’ put the reduction in A&E attendances down to the scheme, but said he could not claim that without conducting further analysis.

He said: ‘I would like it to be, and I hope it is, but we haven’t as yet got that full analysis of the impact of the scheme. I really hope that it has caused that reduction, because that is what it is intended to do. A&E performance has always been a struggle in Durham, certainly over the last few years, and we are working very hard as a commissioning group to try and improve that. This was primary care’s role in reducing winter pressures.’

The CCG has also allocated £2m to the County Durham and Darlington NHS Foundation Trust as part of the bid to improve services over winter.

Elsewhere, weekend opening is now partly up and running some areas of Greater Manchester as part of the Manchester demonstrator project. Spring Lane Surgery is one of the practices taking part in the trials in Radcliffe, forming part of a six-practice federation with shared IT systems and sharing of patient records. So far, it has averaged around 90 patients per weekend in the first two weeks of the trial.

Dr Ajay Kotegaonkar, a GP at the practice, said: ‘Our demonstrator bid started on 2 December so we have done two weekends. The demand is not yet great because it has not yet been well publicised. We anticipate that this will go up as patients understand what services are being provided and when they realise that we are a very good alternative to A&E, walk-in centres and out-of-hours cover services.’

In Central Manchester, one practice in one of the four hub areas, began offering Saturday opening two weeks ago. CCG clinical director Dr Ivan Benett said the CCG was hoping to have Saturday opening in all four locations from the New Year.

He said: ‘It is still early days so it is just picking up activity, but we have got the IT working to support the scheme.’

Seven-day opening in Manchester was accidentally hailed by Conservative leaders as a success during the party’s conference earlier in the autumn, but is only now getting under way.

Note: This article was updated at 11.33 to clarify that patients were seen on both Saturdays and Sundays

Key facts on the North Durham CCG weekend opening scheme

What it does: Provides patients registered on GP lists in Durham, Derwentside and Chester-le-Street areas with GP appointments on Saturdays and Sundays.

How it works: Not all practices are open at the same time - they cross-cover for one another. Some are open on Saturdays, some on Sundays, but patients in the area can always access a GP appointment on the weekend because patients registered with any practice in the CCG area will be diverted to their nearest open surgery. This includes pre-booked appointments as well as emergency appointments coming via referral from 111. The practices also accept referrals of patients from A&E. More than 25,000 additional GP appointments will be available for the duration of the scheme and 15 of the 30 practices also offer nurse appointments. 

Purpose: To improve access to general practice, reduce pressure on emergency services and offer continuous care for patients with long-term health conditions.

Duration of scheme: 1 October - 1 March.

Practices taking part: 30 out of 31 member practices of North Durham CCG.

Funding: £1.2m.

Future: May be extended beyond March 2014 pending a full evaluation.


Source: North Durham CCG



Readers' comments (63)

  • Where are these patients coming from? Has there been a reduction in A & E attendances. Is there less demand for weekday GP appointments. If neither of these then they are just attending because the service is there. Check these numbers before re jigging the whole service.

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  • 7000 patients doesnt represent a success, it will only be a success if longterm it reduced AE attendance and proves to be cheaper...though you have to ask why is it cheaper?

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  • Two points - open the service more and patinets ability / willingness to self care decreases - more work for no benefit
    Secondly the government's trial of this in a few areas for £50m equates to well over £1bn if rolled out. Watch for the premature headlines (which appear to have started) claiming success (like the WICs) and it being rolled out to all GPs for peanuts.

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  • Well what a surprise that the number are being used to fit the original hypothesis, cold hard facts with evidence they daily wail method wins everytime......

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  • If a GP were to be available for 24 hours a day, then he would be used 24 hours a day but the cost would be astronomical. It is because of this that A&E is the most cost effective way of looking after patients out of hours in conjunction with the established OOH providers.
    Presumably the cost of opening GP surgeries at weekends will be deducted from the A&E budget otherwise this madcap idea will strain resources even more.
    The basic question is: can a patient access medical services free of charge, 24 hours a day and is the cost reasonable? The answer is yes.

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  • so 7000 patients for £1.2M is £171 per consult given there's only a fifth of a year that'll be £5m over a year. Makes the bankers seem economical.

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  • makes me wonder why 111 weren't diverting to the commissioned GP OOH system in place already. Agree with earlier comments, increase access breeds increased demand and will always be used.

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  • Brillant success- but I wonder how this fits with the fact that 92% patients felt access was acceptable. Study -random and was 1million patients.
    Its obvious that the whole county76 demand decreased therefore clearly indicating a simple downturn in demand generally which if extrapolated suggests 7000 pts seen and No actual A+E decrease.
    Its true there are lies , damn lies and statistics

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  • Not sure I believe these claims, having done a regular and longstanding Saturday surgery at 2 sites this weekend, where I had 3 DNA's in both sessions and unused emergency slots. Christmas shopping was much more important than seeing the doctor..........

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  • Were they operating instead of the usual OOH service? If they were how many patients did the OOH service see?
    How many patients did the new service see to avoid a single A&E attendance (put another way what was the number needed to treat?) and what was the cost of avoiding that single attendance?
    I find it persistantly fascinating that there never seems to be a full evaluation of these services, just a series of press releases.

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