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GP leaders demand end to seven-day routine access scheme

GP leaders have demanded the Government's flagship scheme to offer routine appointments on Saturdays and Sundays to be scrapped. 

Delegates at the England LMCs conference voted unanimously to 'immediately' withdraw the scheme - including halting any plans to include this in the 'Network DES' in future years - after hearing it has prevented GPs from delivering essential patient care.

They said that the money pumped into the scheme - worth £6 per patient from CCGs alone - should be recycled into routine care.

Evening and weekend appointments have been gradually introduced since 2014, on the basis of a Conservative Party pledge announced by former Prime Minister David Cameron, and taken forward by former health secretary Jeremy Hunt.

The Government and NHS England have continued to pump money into this scheme with specific pledges being made in the GP Forward View, and CCGs given earmarked funding.

However, Pulse has reported that there has been little take-up across the country. 

Dr Anthony O’Brien, from Devon LMC, who proposed the motion, told delegates the scheme has failed to deliver any benefit and threatens out-of-hours services' sustainability. 

He said: 'Improved access has longer appointments, clinics are often not fully booked, they pay good money and give me a chance to catch up on paperwork on a lazy Sunday afternoon. What’s not to like?

'It might be good now but what about in the future? The dangers are, out-of-hours services will continue to flounder as they cannot fill their shifts and that will make our jobs worst on a Monday morning.

'There are no more GPs than there were five years ago but we still have agreed to spread ourselves thinner. Spreading the same amount of jam over a bigger slice of bread loses its flavour.'

He added: 'Are we degrading our professional status by reducing the time you have during the week to provide continuity of care to the chronically sick and replacing with seeing relatively well patients over the weekend? I think we are.

'Improved access is a clear and present danger, potentially changing any good, rewarding Monday to Friday job into monotonous clock in clock out widget counting process on a seven-day rota. However, there’s been a lot of money pumped into this. I think we’re deluding ourselves and drinking from a well that will dry up. We’re here to provide good general practice and improved access is certainly not that.'

BMA GP Committee deputy chair Dr Mark Sanford-Wood said: 'We support this motion. I think it’s implicit that in calling for the end of this scheme we’re also calling for the recycling of that money into general practice and primary care.'

Earlier this year, NHS England primary care director Dr Nikita Kanani told Pulse that the seven-day access will be reviewed to make sure it is 'sensible' for practices, as part of the primary care networks.

Also this year, the GP partnership review found extended access services entice GPs away from practices, as the work is 'easier'.

207 DEVON: That conference calls for the Improved Access Scheme to be immediately withdrawn as:

i. there is no evidence that this scheme is producing any significant benefits

ii. in many areas the scheme is having deleterious effects on staffing emergency out of hours care

iii. incorporating it in the future primary care network DES is likely to lead to many GP practices not signing up for the DES

iv. GPs providing routine appointments seven days a week is a political wish rather than a clinical need and in the light of the crisis facing general practice it is our professional responsibility to explain this to our patients.

CARRIED UNANIMOUSLY

Readers' comments (14)

  • Bad idea. If this is scrapped, the money WILL NOT be put into the GP contract hence we lose access. Worse still, if it is put into the core contract, PCNs will be responsible. Most PCNs are struggling to find a social prescriber never mind OOH GPs

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  • get rid of it PLEASE. Locally OOH are struggling to fill their slots and this means a lot more patients are going straight to A&E at the weekend. It is spreading the available workforce too thin and all this just to fulfil a stupid promise from that wrecker Cameron.

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  • not doing the extra shifts now cause of the pension and tax issue, pay is same as 10 years ago and the same as you can earn as a locum in the week - may be easy shifts but I found them pointless and 111 referrals were terrible. not working nights and weekends is lovely. some people like doing them, others don;t - just not enough of us to cover all things wanted which is the biggest issue.
    Takes 10 years to train a GP from med school to starting point and even then they need a lot of support. So any increase now in numbers aint gonna benefit anyone for a long time to come. More sense to invest in the people you have now so they stay in the NHS. as this isn't happening no reason to stay for any longer than we need to.

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  • Why oh why does new money have to mean new schemes rather than improving the quality of exhisting services?

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  • 100% agree my PCN Extended Access slots work on 50% no show, and never see my own patients its the others who struggle with capacity.

    However not a vote winner, Politicians telling Dr's to buck up and work harder for less is interpreted as the Party are totally about supporting Saving/Caring for the NHS

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  • 100% agree. When we did it, no thanks to Gordon Brown, hardly any working people turned up and DNA rate was high. Now it becomes like a normal surgery. The usual frail, elderly, those with lots of chronic diseases come and the working population is either in bed or enjoying their weekend.Nice to have GPs working though, just in case.....

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  • AT SOME HUBS,THE GPs GET UP TO £100 PER HOUR AND "CAN'T" REFER ANYONE OR DO ANY INVESTIGATIONS.....

    ALL THEY SAY IS "GO AND SEE YOUR OWN GP" TO GET REFERRED/SORTED OUT. IT IS LIKE HAVING A "CRAP" LOCUM THAT YOU CAN'T SACK.

    LOVELY, EASY WORK FOR LOCUM GPs...ANYTHING WITH A WHIFF OF COMPLEXITY AND BACK TO YOUR OWN GP....
    NOBODY WANTS TO ACTUALLY MANAGE THE COMPLEX PATIENTS ANY MORE....THE WHOLE SYSTEM IS A COMPLETE JOKE BUT NOBODY CARES WHAT PARTNERS THINK DESPITE THE FACT THAT WITHOUT PARTNERS GENERAL PRACTICE WOULD NOT EXIST IN ANY EFFECTIVE FORM. I DON'T BLAME THE LOCUMS, THEY HAVE JUST HAD ENOUGH AND HAVE DONE SOMETHING ABOUT IT-MADE THEIR OWN LIVES BETTER.....

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  • I suspect we are heading towards wholesale dumping of PCNs after all.
    Next time, we'll be pushing for viable GP:patient ratios, hence longer to spend with patients.
    Downskilling and stratifying is not the way...
    Immediate plan for GP rescue? Obviously money, bigtime, for retired and refusenik GPs currently hiding in the wings (240,000 docs are registered with GMC).
    We need to fight for or lose our NHS model of general practice, because managed care does not care what we think once we've signed the contract.

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  • GPs, LMCs and BMAs are focussing away from the main threat to General Practice- PCNs. The PCNs were apparently formed to relieve staffing problems and relieve pressure on practices. It’s become such a nightmare- employment, VAT, and more importantly CCGs and systems now wanting to commission all their services through PCNS, and wanting Clinical Directors to help forming ICPs. The system has gone mad. We need to get rid of PCNs and put money directly into core GMS

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  • Vinci Ho

    Ha ha ha
    I am probably one of the few PCN CDs who does not f***i g believe what PCNs are asked to do by NHS England . Thanks to the protagonists of seven-day GP opening (well , we know who they were) , out of hour services were sacrificed needlessly.

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