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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)

  • Dear Mr Kabir 10 04
    It is quite apparent that you have some type of personal agenda and axe to grind. Likley with your current employers. I think that such comments are disgraceful and not professional

    obviously,you are offended.i wonder why?mr kabir is only telling the truth.no?

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  • I don't think the policy is that all GPs have to work 8-8 7 days a week?
    Well with no money to fund any extra GPs YES we will be having to if this gets shoved down our throats like everything else. As to 'Mr Kabir' trying to say about GPs wasting money listen up! I am female and having to pay the whole mortgage, my hhusbannd earns very little, I was prevented from having kids thanks to a premature menopause striking before we could save enough to make having a kid feasible. I have no relatives working in the medical profession and never have - I was a black sheep in that respect! If I had been able to have kids although quite frankly looking at the state of this country I am beginning to feel that this was probably not a bad thing in the long run, they would have gone to normal school and not private! You are voicing stereotyped, offensive and inaccurate views and I'm sure at least 60 hours plus many hours of work at home I work as hard as you! Lucky to get anything to eat most days let alone a glass of water or a trip to the toilet!
    If you don't have an educated or relevant view keep it to yourself!

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  • And here we go again!! David Cameron falls ever deeper into "the patient trap", pandering to the every wim of the patient population. Where will this end? I dread to think. It seems as though the government and the general public wil not be satisfied until we are all chained to our desks 24 hours a day with no life outside of work whatsoever. Excuse me but we are human beings too! Also when will I get to see my bank manager/solicitor/plumber and electrician at 3 o clock in the morning ?? I await a government directive on their working hours too. Even though A&E departments are full to the rafters with patients attending inapporppriately, it does not mean that we are sitting on our behinds while these patients are A&E. We are also stretched to the limit of our capcity and in some cases way beyond. Offering these extra appointments will not solve the problem. Thes appointments will soon become saturated as well and then what will the next step be?. Instead of blaming doctors aand management and nurses and chaging their behaviour why can we not start to look at patient behaviour and abuse of the service! Patients need to dtart paying supplements for these appointments to make them appreciate the value of this precious time. Money always focuses peoples minds and thinking!!

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  • Usual anger from my colleagues - let's all quit the nhs, all it will take is one CCG, that will get the government listening. Can u imagine a government wanting re-election letting GP's go the way of the dentists?? It won't happen, we would get what we deserve. Courage of convictions is all it would take. Any CCG leaders game????

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  • I FEEL GPS SHOULD STAND TOGETHER AND NOT LET THE POLITICAL CLASS DICTATE TERMS FOR THEIR OWN MILEAGE.IF GPS HAVE TO OPEN 8-8 AND 7DAYS A WEEK WAHAT ABOUT HOSPITALS OP APPTS AND HOW CAN PATIENTS ACCESS THEM IN OOH WHY THIS RULE DOESNT NOT APPLY TO THEM.GPS ARE ALSO HUMAN AND WE HAVE FAMILY AND WE CANT JSUT BE THERE TO SERVE ONLY PEOPLE AND NOT TAKE CARE OF OUR OWN LIFE,WHY DO POLITICIANS NOT WORK 8-8 AND 7 DAYS A WEEK.

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  • Just all remember what happened last year with cutting of funding for extended hours(presumably because they think it has become part of core work!).Many of my local colleagues threw in the towel and stopped doing the extended hours ,as operating almost at a loss. Stupidly we continued and are open 7am to 8pm 3 days a week.Despite being the only ones in our area to do this we get the worst figures in the patient access survey for satisfaction with opening hours.Give the punters more and they then just expect even more. I am in my late 40s and on my knees,I see very little of my children at all as it is. I simply will NOT do this,it is purely pandering to political whims/daily mail readers. There is a huge difference between wants and needs.don't be fooled by any suggestion of extra funding-they will whip it away as soon as we have all bent over and done it as we have repeatedly done over the years-and look where it have left us,knackered,burnt out,disillusioned-need I go on. There are not enough of us to cover what we are doing now let alone 84hrs a week.

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  • Bit of a useless reply from the BMA really.
    No wonder we are getting down over so easily.
    http://bma.org.uk/news-views-analysis/news/2013/september/extended-hours-pilot-must-tackle-gp-shortage

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  • Please leave the A+E consultants out of this. I am a GP who also works in a Hospital. A+E consultants do 80 hour weekends - you remember those ? from Fri 9am to Mon 5 pm, sometimes with a total of 4-5 sleep. I know one who crashed the car going home after one ot these.
    Time for the BMA/ GPC to define safe working hours before everyone either is burnt out or left.

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  • Access 8am-8pm, including Saturday and Sunday

    Reality : extended hours funding was cut this year. There are not enough GPs to staff this and there is already an out of hours service which is stretched to the limit. .

    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

    Reality: Doctors need to examine their patients.
    We already do lots of telephone consultations and triage. There are not enough resources to answer emails all day long - this would lead to complete paralysis.

    Electronic prescriptions and online booking of appointments

    Reality: Already exists in many areas though some practices computers are not powerful enough to cope with these services.

    Easier, online registration and choice of practice

    Reality: Technology already under development. Needs careful evaluation.

    Joined up services with urgent care and out-of-hours care to ensure rapid walk-in access to care

    Reality: Tried already but some Darzi centres were closed due to lack of funds.

    Greater flexibility about how people access general practice, for instance with the option to visit a number of GP surgery sites in their area

    Reality: GP shopping is known to increase clinical risk and can lead to poor care.

    Better access to ‘telecare’ to help sick people stay comfortable at home, as well as to healthy living apps

    Reality: lacks evidence base. A variety of health apps are already available but concerns have been raised about lack of quality control and regulation.

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  • If I am not mistaken the extra hours worked [contracted hours-not real hours which we know are much longer due to management] amount to 40hrs per week on top of a 52.5 hr week currently.
    Taking into account the extra management required this amounts to doubling the provision.
    This should entail doubling the budget and the rental payment.
    Not going to happen I think.

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