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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)

  • Devil..naughty

    How many doctors are earning £150k

    Virtually none in clinical practice unless they work privately... or work for pharma!

    I think you should change your name to ' Daily mail agent' !

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  • The supply side is essentailly impossible to solve, but may be helped by more money direct to us. Tackling the demand side continues to be overlooked. Thresholds to seek help are just way too low for an open access system. Counting waiting times is pointless as we all know they will be 'too long' but unimprovable, and meaningless anyway as there are too many variables that the administrators will not bother to try to pick out.

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  • Good practices have good access so that urgent stuff gets seen without delay. Many practices simply have too many patients per gp to provide a good service. More money ok, but i want to sleep at night. Our paymasters are right to push us on this. The best way of measuring it is already being done which is the patient satisfaction survey. Results show massive variation and access pretty much inversely related to patient list per gp wte.

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  • Jo - you need to move out of hospital - thats low as an average total take home per WTE around here. Interestingly practices achieve this in several ways. some run really high lists per GP, have tiny costs. some have large non nhs incomes or dispense. some have utilized skill mix massively ie few GPs and lots of AHPs. A lot are working very hard for the money. Sounds like we do longer surgeries :-) Dont forget that gross figure - includes Employers NI contributions and Pension Contributions which artificially inflates it against an employee - also loss of personal allowance.. NI rises...lack of any benefits - means the take home isnt what it once was..

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  • @watchdoc - speaks sense. almost every practice runs its appointment system differently - they certainly record it differently. what is good do you measure that - look at the mess the 4hr A&E target has got people into - last thing we need is more targets..

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  • David Banner

    When Blair introduced 48 hr access targets, most surgeries replaced advanced appointments with exclusive "book on the day". Box ticked, but huge patient dissatisfaction. If we all have to publish our waiting times, the same tactics will be used. Cynical creative accounting will merely manufacture the illusion of better Access.
    If the public want more appointments, they have to be prepared to pay more in taxes or accept dentist-style charging. This Name & Shame exercise will only drive even more good people to the exit.

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  • @Devils Advocate
    Some targets on the side of Jeremy Hunt would be pretty useful.

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  • Pay for bronze get bronze,mate.

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  • I work in pharma! left GP a few years ago

    Work very hard but no where near what was being done in my practice.

    Again although practicing GP's should try hard to be efficient - the reward for greater efficiency is greater medico-legal risk.
    NHSE are happy for that cost to be transferred to you.

    The simple fact is GMS contracts is funded for patient needs not wants and until that funding issue is sorted you'll never be in a position to offer adequate appts.

    As to what GP's are worth -those that are still at the coalface deserve a lot more then they get - based on their efficiency and ability to deal with risk. UK general practice is grossly underpaid.
    If it does move to a private or dental model - drs would benefit hugely.

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  • @angus - agree - while some of what i say is just to try and shake the tree of apathy and despair - he is in my opinion a moron. i can see no reason to push the 4 hour target - i dont see how it wins him or the tories votes. what does it even mean. you are assessed on arrival and triaged. the more urgent dealt with first - why should everyone be dealt with in 4 hours. we know not everyone is dealt with -they are just admitted as a 0 day Length of stay putting up the cost... ARGH!!!!!

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