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Independents' Day

GPs to open until 8pm every day under £50m 'pioneer' programme

Groups of GPs in nine areas will be paid to open until 8pm every day - including weekends - under a Government scheme to boost access to practices that it intends to roll out across the country.

The nine trial areas will also test out a variety of ‘forward-thinking services’ for patients, such as greater use of Skype, email and phone consultations to further boost access to GPs through a £50m ‘challenge fund’.

The Government said the pioneer scheme will launch in 2014/15, with a view to rolling out the scheme across England if the trial is successful in reducing pressure on hospital services.

It comes as CQC chief inspector Professor Steve Field confirmed comments made over the weekend that he would be looking for ‘brilliant access’ when he is inspecting GP practices.

What groups of practices will be expected to provide:

  • Access 8am-8pm, including Saturday and Sunday
  • Flexible access including email, Skype and phone consultations for those who might prefer it to face-to-face, when it is safe to do so
  • Electronic prescriptions and online booking of appointments
  • Easier, online registration and choice of practice
  • Joined up services with urgent care and out-of-hours care to ensure rapid walk-in access to care
  • Greater flexibility about how people access general practice, for instance with the option to visit a number of GP surgery sites in their area
  • Better access to ‘telecare’ to help sick people stay comfortable at home, as well as to healthy living apps

Source: Department of Health

The extended-hours scheme is already due to be trialed in practices in Manchester.

Prime Minister David Cameron said: ‘Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life. We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week.’

‘We also want greater flexibility, so people can speak to their family doctor on the phone, send them an email or even speak to them on Skype.’

He told BBC Breakfast that he was aware that GPs work very hard, but that the move was required to reduce the pressure on A&E departments.

He said: ‘I live next door to a GP in my consistuency - I know how hard they work.’

Health secretary Jeremy Hunt said: ‘We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people. Cutting-edge GP practices here in Manchester are leading the way, and we want many more patients across the country to benefit.’

Professor Field added: ‘This move towards seven day services is great news for patients, and should be embraced by GPs. I want to see brilliant access to GP services for patients across the country, and will be assessing this in each practice I inspect.’

National Association of Primary Care chair Dr Charles Alessi said: ‘This is an opportunity for practices to change the way they work. In other words, to be able to improve access on a seven-day-a-week basis. It is a chance to experiment with new ways of working in their patient populations.’

‘Of course it is a good idea and it is not just for general practice. It would really be a lost opportunity if only general practice moved to seven-day working and we still had other parts of the NHS which were working five days a week. This is about a whole change to the way we work, and general practice is part of that.’

But outgoing RCGP chair Dr Clare Gerada warned the Government of putting political priorities ahead of patients’ needs.

She said: ‘I think this was part of the 2008 Labour party policy, with the Darzi centres. Many of the walk-in clinics and Darzi centres are being shut down because of resources, but to me it is just a continuation of that policy.’

‘My worry is you have to choose between access, affordability and continuity. You can’t have all three, and what we desperately need at the moment is not access but continuity because that is how we improve the lives of our patients with long term conditions.’

‘In the ideal world, yes of course it would be great to have 8am to 8pm, 365 days-a-year opening. But we are not in the ideal world, we are 10,000 GPs short and GPs are at the lowest of their ebbs since I can ever remember. We need a joined up strategy akin to RCGP’s 2022 vision for general practices, not piecemeal announcements that I suspect are directed at, dare I say, the “voting classes”.’

GPC deputy chair Dr Richard Vautrey added: ‘I think it is important here to delve beneath the headlines. These are pilots and they are being paid for, and it shows that general practice can do more if the resources are provided for us to do that.’

‘We would like for more GPs to offer [increased access] but we can’t do, it would be a disaster, because it would mean spreading the service even more thinly. If we expect GPs who are already working 53+ hours a week to work 84 hours a week then that will reduce the quality of the service and decrease patient satisfaction, because they will not be able to see their regular GP when they want to see them.’

‘It is essential that we see an increase in investment in general practice, so that we can employ and take on more GPs, expand our practices and work together, but this announcement is really about almost reinventing GP co-ops, and that sounds very much like Groundhog Day.’

This story was corrected on 9 October after it emerged that the extended hours pilot the Government had praised as ‘successful’ will not begin seeing patients until Christmas. Read the full story here.

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Readers' comments (77)

  • Hazel Drury

    Was it just me or did I hear on Today that Mr. Cameron said there were increases in the number of doctors to cope with this?? Really?

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  • This is fine because my staff have all said they will come in on the weekend for no extra money!

    We only have one cleaner for our small surgery but she will now work seven days a week for the same wage!

    One of my partners cannot help out as he goes away on weekends. The other works on the OOH on two shifts plus extra training hours.

    I do not care as I have no life and would like to do something on the weekend.

    All is well in the best of all possible health systems. .

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  • Naturally we will have full access to all hospital facilities during these periodsie bloods, microbiology, ultrasound XRay, physio, OT since as GPs we are part of a team not workers in isolation.

    What was that Prof? No? Why not Prof? Whilst you are answering that one please tell us how many hours a day a GP Should work ? How many hours a week? How many patient contacts?

    I am sure such a wise academic GP should inform us lesser mortals who actually do the work if the answers to such boring questions.

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  • So GPs will just bend over and take it, just like they have always done. Too many in this profession are wet cloths and not prepared to properly fight together for the resources we need.

    Strike anyone? No hands at all? No, I thought not....

    Sooner I can get out into private work the better. The life of a GP STINKS now.

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  • Most of us are looking at this from a GP partner perspective. Other GPs look at things from a commercial perspective. Corporately if I could hire few GPs to run the services then I might just about make it pay. This does not open access to good continuity of care with their "named" GP, but ticks the boxes for the government and press making the lazy GPs work for their money and this will suit a person who feels that seeing a doctor on Sunday rather than being with their friends family as they cannot bear to give up a moment of work to look after their own health. We are a divided profession, this suits the government and it also suits our high-profile colleagues on their route to awards and the CMO job.

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  • Can someone remind me what happened with the funding for extended hours last year.....

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  • "many GPs abuse public money to send their own children to private school but pay their staffs peanuts"

    I can not believe I am reading this!

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  • It doesn't make sense. If the aim as stated is to reduce pressure on A&E, the target population has to be those who perceive that they have a medically urgent condition. We already have out-of-hours service for that. There is a shortage of suitably qualified doctors. If those doctors are pulled out of OOH services to offer routine appointments in their own surgeries, it seems at least possible that A&E attendances will go up.

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  • Anon. @ 1123 makes a good point. Before I (thankfully) took VER 6 months ago I regularly asked this question when working 12 hour days endlessly triaging ~ 100 phone calls per day & seeing ~ 30 patients per day in addition without a break. Pilots, bus & lorry drivers, to name a few, have statutory limits on their hours/ quantity of work on the grounds of public safety - but then again they are doing an important, valued job....

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  • I retired 3 years ago, thankfully, but I still like to keep abreast of what's going on in the world of General Practice. My, how things have changed. The only way General Practice and indeed the Health Service as a whole can survive as far I can see, is to remove control from the Government!! (Sadly unlikely to happen) Apart from providing funding they should not be allowed anywhere near the service which is merely a political football, with much of the funding wasted on ludicrous and all too frequent changes. Unnecessary administrative involvement consequently swallows up the cash which should be targeted at patient care. Don't let the b******s get you down . Best of luck!

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