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GP appointment waiting times to be published under new access drive

GP practices are to have their waiting times for appointments published under a drive to improve access, says NHS chief executive Simon Stevens.

Speaking in front of the cross-party House of Commons Public Accounts Committee today, Mr Stevens said that NHS England would begin collecting waiting times data this year.

Mr Stevens added that he wanted to see access to GP appointments improving as a result of the increased investment into the general practice workforce.

At the hearing, that followed a critical report from the National Audit Office that said the Government had a ‘crude’ understanding of current demand and capacity.

 But Mr Stevens said that NHS England was significantly increasing its measurements of general practice, including a scheme for practices to report their workload, and an audit of waiting times.

He told MPs: ‘We want to have more information on the availability of GP appointments for routine conditions, and we are going to start collecting those data through the course of this year.

‘We’re going to publish those so people can see what waiting times are, I think that will be good for patients, it will be good for GPs, actually.’

He added that, while NHS England recognises general practice is under significant strain, it was also receiving investment – particularly in new workforce - and ‘therefore it’s reasonable to expect, on the back of that, improved access’.

Stevens added that this year they would also introduce a ‘GP practice workload tool to measure what is happening inside primary care’.

He told the PAC that the lack of this data on workload pressures had contributed to historic underfunding and was one of the reasons ‘GP services have lost out compared to other parts of the NHS’.

Pulse has asked NHS England to clarify whether waiting times data would be published at individual practice level.

GP leaders said no details had been worked out and it would not be straightforward. GPC deputy chair Dr Richard Vautrey told Pulse: 'Practices operate in varying ways and there are patients who want to wait to see a GP of their choice, how do you qualify that and compare patients who will happily see any GP for a particular episode of care?'

The National Audit Office report highlighted some areas of the country where practices were closing once a week or more during core hours, despite in some cases also receiving funding from the extended access DES.

The panel today clarified that 75% of these practices were located in roughly 50 of the 211 CCGs in England.

NHS England’s director of commissioning development Rosamond Roughton said these patterns were ‘concentrated in very particular parts of the country’ without obvious reason.

She added there was some confusion in practices' response - as follow up queries with some practices revealed many still provide appointment booking, or prescriptions collection services, but that publishing the data had impacted their behaviour.

Ms Roughton said: ‘In many parts of the country [practices] saw the data and were taken aback: "Why are some practices closing for half day when we’re not?”

‘In some ways we know peer pressure is one of the ways we can see change happen.'

She said NHS England would not be afraid to also use contractual penalties to change these behaviours, but intended to take a ‘supportive’ approach initially as many of these practices have acute workforce difficulties.

RCGP chair Professor Helen-Stokes Lampard said that 'data can be a very useful tool in improving patient care' but 'data on waiting times should not be used as a measure of performance, as this will be affected by too many variables'.

'Average waiting times will be influenced by population demographics and deprivation levels in an area, for example, as well as factors at a practice level, such as recruitment difficulties,' she said.

She added: 'The College has not shied away from highlighting the issue of soaring waiting times for patients to see their GP – and we want to work with NHS England and others to improve the service for patients, right across the NHS...

It is essential that any data derived from general practice is used in a meaningful way to inform and improve the health service and the care that patients receive, and is not simply used as a stick to beat hard working GPs and our teams with.

Readers' comments (48)

  • According to my contract I have to meet the reasonable needs of my patients not provide access determined by anycase how does increased GP access do anything but increase referrals and prescribing costs

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  • I strongly believe that if something costs us nothing then we come to value it very little.

    As GPs, if we make ourselves instantly available then we'll be bothered for every trifling condition and because we'll be seen as doctors for trifling conditions, we'll be valued as such.

    In order to manage demand and for us to retain some dignity I believe that patients must suffer some cost in order to get to GP treatment. Of course, while the NHS remains free at the point of delivery that cost cannot be financial so it must be in time and/or inconvenience.

    For us to deliver safe and effective care I suggest that patients should be seen in a time appropriate to the urgency and importance of their problem and our appointment systems must make this possible. At times delay may be good or appropriate. I cannot see how any crude measure of average waiting time for an appointment can possibly assess this.

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  • Get the impression these guys at the top have nothing else to do except look for goblins. Next, expect your toilet regime to be published on websites - Dr X visited the loo and spent 1 min and 30 sec more than the expected xy minutes. Name and shame the gp and refer to gmc.
    At least we can see that somebody at the top is twiddling his thumbs real hard and not idling with stench emanating from the backside.

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  • A good way to herd more of us toward the exits.Well done that man.To be honest I dont really care any more that what resilience training does for your psyche.

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  • The devil is living up to his name.

    Access is a function of funding, nothing more or less.

    GMS was designed to fund 50-55 contacts per 1000 patients.

    Experimental schemes to increase access sometimes work short term, but invariably only reset expectations.

    Also there is a significant transfer in risk cost which is the elephant which NHSE are hoping just goes away.

    Ask all those who take on telephone triage and the MDOs are starting to factor the increased risk associated with these.

    The next transfer risk policy is versions of Web based systems that do not work but do open the door to email contact and the workload and risk that will carry.

    Have no doubt that is what NHSE want.

    And they will not stand by you in court!

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  • We used to do telephone triage with unlimited spaces. This worked for a number of years, but the demand for access, because of the variety of different problems that have been well documented all over the place, lead to the situation where we could just go on and on. Because of this we have limited the number of spaces. I believe that copayment is the only way to go. This allows some degree of breaks on demand, but perhaps more importantly allows resources for more work. It works everywhere else in the world.

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  • This lot only want co-payment with large conglomerates and no independent GPs.They want a malleable workforce who will comply and not question management BS. Therfore the ongoing destruction/attrition of the medical workforce will continue.We are fighting one way and being shot in the back by our generals on the frontline. More cold liquid resilience from the fridge methinks.

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  • Jmd

    This is long due.
    There should be a distinction between telephone triage( my personal view,this should be discarded) and F2F consultations.
    This will also iron out varaibilities in primary care practice and help to bring all practices to a level playing field with exceptions.
    As this will allow workload measurements and incentives and resources made available.
    This should also accompany by figures of pts attending AED during opening hours.

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  • Dr Cundy you missed the point of my piece. I never said seeing johnny in 9 mins was right. i actually said we need better signposting (in my surgery as thats crazy) The point was that you get get to a point when you have seen everyone. the demand isn't limitless. the other point i was trying to make was people bleat about funding - yet 1. the service they deliver is massively different in terms of hours of patient contact 2. the level of take home pay isn't just based on your funding (nhs income) its based on - how well you run your practice - what other income you bring in and what your expenses are. problem is GPs are often bad business people and dont understand finances - often many dont invest enough in their own business. How many of you hire a minor surgery staff grade to do yours and your neighbouring practices minor ops? how many of you sit and see pill checks when a nurse can do this? locally our local council tendered coil fittings. for around £90. Loads of practices went.. thats a triple appointment with a GP and a HCA and it will cost us more than £90 to do it. We have 1 nurse doing 3 an hour. £270 in - about £50 spent. perhaps the people on here are fine - but I've been in 50+ practices and the level of stuck in the mud is huge. yes it would be nice if the government gave us a huge income rise but its not going to... anyway who said doctors should be earning £150K?

    maybe i should change my name to "trying to shake the profession out of complacency" :-)

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  • There is no point in publishing this stuff as the system is too complex and variable to allow accurate comparison. It is similar to the hours I have spent pouring over variable referral rates between practices that end up being attributed to all sorts of factors. Is a short wait good ( 9 mins) or is a long wait good ? - who knows.

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