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GPs go forth

BMA to support further seven-day working for urgent care

The BMA will support the Government’s move towards greater seven-day working, but has said this must focus on emergency and urgent care services and not routine GP access if current resource levels are maintained.

In a policy paper published over the weekend, the BMA said it will negotiate with the Government to boost access to emergency, urgent and acute services but criticised ministers for focusing on increasing access to routine care instead.

The BMA also said it will work with the Government on the £50m GP practice seven-day-opening ‘pioneer’ trial but said that this policy, and any further attempts to increase seven-day GP access - including health secretary Jeremy Hunt’s demands for a ‘named GP’ for each vulnerable patient - will not succeed unless resource levels increase.

The paper said: ‘The BMA believes that urgent and emergency services should be the priority for investment to bring the standard up to the very best, every day. As such, care quality improvement should be the primary driver of seven-day service development for acutely ill patients. Only then can the debate start as to whether a full weekday service can also be afforded at nights, weekends and bank holidays.’

‘In the current and foreseeable economic climate, with huge financial pressure on the NHS, the BMA does not believe that the resources could be freed up to deliver routine and elective services seven days a week.’

The policy paper highlighted the prime minister’s announcement at the Conservative Party conference for a pilot scheme in England designed to give patients access to their GP from 8am-8pm, seven days a week, and health secretary Jeremy Hunt’s plans for a named GP for each vulnerable older patient.

It added: ‘These policy announcements appear to focus primarily on extending availability of routine treatment and services in primary care, rather than raising the quality of weekend and out-of-hours urgent and acute services.’

However, the paper concluded that the BMA should be closely involved in the work to take seven-day working forward, to highlight the changes required to doctors’ working patterns and the implications on resources available.

It said: ‘Fundamentally, the BMA believes that NHS care should be of the same high quality across seven days.’

‘In order to achieve this, the BMA stands ready to work with all stakeholders to achieve a clear understanding of what working patterns will be required… as well as the resource implications.’

‘We will support GPs taking part in the recently announced pilots that aim to extend access, although we remain concerned that the current workforce is stretched trying to provide high quality care within current access arrangements. We must ensure that the pilot is used to assess the most cost effective way of improving patient outcomes by extending access to general practice.’

BMA chair Dr Mark Porter said: ‘Patients should have greater access to high quality care throughout the week and doctors should be part of the solution when it comes to identifying how the NHS can achieve this.’

‘We are already in negotiations with the Government on how to develop working patterns which meet patient demand and deliver greater consultant presence at weekends, while safeguarding the need for a healthy work-life balance.’

‘Given the NHS has finite resources we have to look at what services can be provided within the existing workforce and budget. We believe delivering consistently high quality emergency, urgent and acute services across seven days should be the priority.’

Readers' comments (14)

  • Vinci Ho

    In essence , it is all about improving the standard of current out of hours cover. Politically , it appears that the responsibility would have to return to GPs but practically delivered by for instance GP co-operatives (back to the time before 2004).
    But even to improve current OOH cover will need further funding and investment especially in rural areas.
    Please send in your comments

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  • How is this any different from what the OOH services do at the moment?

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  • Vinci Ho 9.33 is right. the best way to improve out of hours G.P. care would be to resurrect the G.P cooperatives which, prior to 2004, worked very well and with a high level of doctor and patient satisfaction. However, for this model there are significant running costs and without appropriate funding, they will not happen. If J.H is serious about improving OOH care, let him make the funding available, and, as before, G.P's will do most of the rest. Why ignore history, the answer is there.

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  • Dont people realise because OOH and urgent care services are so misuesd, 50% of pts do not need to see a doctor, 30% could wait for surgery , thats why accident and emergency is so full all the time.
    Who is to say it wont happen when there will be 7 days GP surgeries open
    Total waste of public money

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  • All these things will go on without my input. If I have to finance or staff OOHs or 7 day working I'm off.

    I am in my 40s . I have lowered my expectation for a pension and will either be a kept woman or I may do two sessions a week salaried until British General Practice sorts itself out. It will be on my terms, not Jeremy Hunt's.

    I would only do the bare minimum so that I have not completely closed the door on general practice. I do not intend to help out politicians or be corporate GP fodder. This will be my own protest action as the BMA are spineless.

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  • Geoffrey Hall -- you are being very correct but as we all know that will not happen , Medicine is just as complex as before but with the advent of internet , pt education and lets be honest abuse/demoralization and blatant disregard fro the profession from so many angles Co-ops will struggle to do it as well as we would like to

    I suspect --contracts will be tendered, big companies will charge as they will supply quicker care /investigations tests etc / They will have better premises, more advertising and will not be restricted to not promote their own product

    The NHS as we know it will have a few champions here and there , but by enlarge a dying breed

    We have let ourselves be trampled abused threatened maligned so much there is no turning back . ER was always available for emergencies
    OOH great concept but you are right needs funding and it will not happen as it will be expected to be done out of the goodness of Dr hearts , because money is involved and its easy to play the trump card of doctors not caring about people and so on

    We have to admit we are donkeys working away , and there are some shire horses called Boxer who will carry on doing the work of 10 donkeys but eventually when they are worn out these Boxers will have the knackers come for them , so much for loyalty and hard work ..just sounds great in books and folklore

    Orson Welles , if you like English literature , says and I believe eerily predicting a future ( albeit related to the Russian Revolution in 1945- but its an interesting read) with his book Animal Farm . Although the concept starts with all animals are equal what we have now is Old Major , Snowball and Napoleon doing whatever they want and eventually what happens is that the motto changes too All animals are equal, but some animals are more equal than others... In the end Napoleon and Snowball will blend into society ..and as for Us we will be like tears in the rain

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  • Orson Wells - Animal Farm - shurely some mistake?

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  • Vinci Ho

    Orson Welles- Citizen Kane , movie classic
    George Orwell- Animal Farm , my favourite book

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  • Can Heremy Junt and the BMA define how many hours a week is the maximum it is safe for a GP to work?.

    How many patient contacts a day are safe?

    I think we should be told

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  • I echo the thoughts of anon 1:26pm.

    Although I'm a man and the higher earner of my household, I will not take on this responsibility regardless of how much money they give me. Partners are fully aware their financial responsibilities extends far beyond their work - in fact to their personal assets. So if I employ more staff, rent out infrastructures, get a loan out to cover the bigger cash flow, not only will I be taking on unmanagable amount of work, but I will be putting my home, my savings, my family's livlihood at risk. If I set up a limited company, I'll be subjected to 20% cooporate tax, even before I get a "salary". Either way it's loose loose for GPs.

    I write this having had an argument with my wife last weekend over me spending increasingly more hours at the office and hardly ever seeing my family. Infact, some of my patients probably spend more time with me now then my kids!

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