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Independents' Day

Quarter of PM's seven-day GP access pilots have cut opening hours

Exclusive Many of the seven-day GP access pilot areas have reduced their extended hours in light of poor demand less than a year after they were rolled out, Pulse can reveal.

Our investigation into the status of the Prime Minister’s ‘Challenge Fund’ pilots across England has found that some have completely cut Sunday GP appointments and, despite advertising, were experiencing less than expected patient demand.

Schemes in Darlington, Hereford and Devon, Cornwall and Isles of Scilly have had to cut back on offering extended access and Sunday access has been scrapped entirely in some areas of NHS Kernow CCG.

Pulse conducted the investigation after revealing that the North Yorkshire Challenge Fund pilot has abandoned evening and weekend appointments altogether, while in west Hertfordshire slow demand has prompted commissioners to significantly reduce Sunday opening.

The investigation also revealed that in another pilot area, only 40% of appointments were filled.

Rolling out seven-day GP appointments to all patients forms part of the Conservative Government’s election pledges but GP leaders have warned these are Government ‘pipe dreams’ which should be abandoned in favour of finding a solution to the crisis of in-hours GP appointment demand.

NHS England told Pulse:

  • The Caring for Darlington Beyond Tomorrow pilot, which started in October 2014 and involved around 94,000 patients at ten practices in Darlington having 8am to 6.30pm access on weekends, reduced hours but were ‘replaced with another service’, NHS England said;
  • The Herefordshire pilot, which saw patients across 24 practices in this pilot having greater access to GP services up to 8pm, seven days a week, also decreased its hours.

Meanwhile, an NHS Kernow CCG spokesperson said: ‘The various pilot projects have reported much lower use on Sundays than on Saturdays and in those cases the pilots have stopped offering a Sunday service to reflect longer term sustainability planning.

‘We are in the process of evaluating our schemes to determine if our projects can be sustained in the longer term.’

The investigation, encompassing all of the 20 wave one Challenge Fund pilots, revealed that these areas were not alone in experiencing slow demand, with NHS Bristol CCG board papers revealing that despite information ‘being repeatedly communicated through different channels, media, people’ uptake for extended access ‘remains at 40%’.

Despite this, the CCG has no intention to review hours, with a spokesperson saying that ‘there is no evidence to suggest that it is required’.

However NHS England said there was also examples of Challenge Fund pilots which have further extended opening hour - five in total, or 26% of all pilots - including those in Morecambe; Derbyshire and Nottinghamshire; Brighton and Hove as well as the Care UK ‘superpractice’.

NHS England told Pulse that the wave one Challenge Fund pilots ‘have been very successful overall with over seven million patients having improved access to GP services’ and that no other area, north Yorkshire aside, has as yet decided on whether to continue offering seven-day services beyond the end of the pilot period.

CCGs will be required to fund the schemes themselves after the Challenge Fund funding come to an end in September.

According to an NHC England spokesperson, the CCGs are expected to make decisions as to whether to continue funding after September, but ‘it is highly likely that in most cases elements of the pilots will be extended’.

Pulse also found that one of the 37 areas involved in the wave two pilots, most of which have not yet started, will not be providing patients with weekend access. Instead Oxfordshire is set to focus entirely on extending weekday access.

The Government has funded the first wave by £50 million plus an unspecified extension sum, while the second wave is receiving £100 million.


Related images

  • opening hours special report  PPL - online

Readers' comments (16)

  • There could be more. You never heard me say this, but there has been a whisper - just a whisper, mind, nothing more than hearsay - that a Challenge Fund provider in West Cumbria is also on the point of reducing its weekend opening hours due to lack of customer demand.

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  • Presumably funding has to be returned. Can it be diverted to fund OOH properly?

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  • The cost per patient treated out of hours under this scheme works out around £211 .

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  • For several years maybe 7 years ago
    I offered sat and 8 pm weekly clinics
    Patients preferred shopping eating or coronation St
    My receptionist got fed up after a year
    Closed clinics
    Have to say when I told patients they were shocked and said they would have come if they knew
    Despite lots of info I think everyone needs to know and it has to be the popular doctor

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  • Ivan?

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  • GP hours are going to be cut because of demoralised GP status and numbers.
    GMC MPTS have been taking NHS complaints due to their Non evidence basedcpolicies ,not patients complaints against GPs as sacrosanct and tortured Gps to distraction ,suicides or resignations.
    A demoralised workforce of people who spent up to £5000,00 and extraneous effort in their education have seen it wasted away.
    There is a red line line GPs have to draw.Refofrm The Health service the way it is run or face the consequences.The BMA and Medical Defence and Protection Societies should better their support of paying members,not leve them to be consumed by the wolves

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  • Ivan Benett

    Yes, I'm here. We found that take up improved the longer the service went on. It is true also that the damand at weekends was less on Sundays than Saturdays. I think this is mostly because people don't yet know about it in their localities. Certainly people at work or who have carers at work valued the service. We have also reduced the attendance at A&E for 'Primary Care stream' patients statistically and I believe, clinically, significantly.
    Of people attending A&E 2:6 have been referred by GPs or come in with ambulances. These cannot reasonably be influenced by extending GPs service. Out of the remaining 4:6 who self-refer we have reduced one of those six attendances. Many of the others are appropriate to attend A&E.
    The biggest impact will be when the service can meet it's potential of a full Primary Care service including nurses and diagnostics. Later we will be able to move more planned care hospital activity into the extended hours hubs and link more with early evening community services. The potential for shift of activity out of hospital, and investment into the increased Primary Care capacity is really quite exciting. It also offers new GPs a chance to be flexible with their work time and careers. No GP is forced to work more than they want to, and many prefer the flexibility.
    As for costs. Our extended hours service costs net £3 per patient per year - less than the cost of a bus fare! This is an investment well worth it for those who can use it, and for the future potential benefits, which are yet to be realised.
    Before people say it again. Yes we need to plan for more appropriate workforce in terms of skill mix and numbers. Not having this is not a reason for not doing it, but for planning to develop that workforce. Over the horizon, well, on the horizon are Physician Assistants, more specialist nurses and hospital specialist training which may well do more in the community. Anyone who wants more detail on our plans please email me - It would be good to have a grown up discussion about the future of our profession.

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  • We've just had a meeting about it.

    Proposed to us to do huge surgery every 8 weeks on Sat or Sun seeing other practices' patients for a few hundred quid.
    Not for me mate.

    After tax and all that risk, I for one am not doing it.
    I'm not propping up Hunt's mindless visions for weekend utopia.

    I'll sell my sessions to a gullible newbie - some local doctors seem to love these sessions

    Meanwhile, I have a life

    Bye, I'm out

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  • thanks Ivan for the updates

    I don't agree with 7day opening and the way in which this is being implemented at a time when I think funding pressures should really make us think hard about where we spend our limited resources;

    thanks however for posting here, as yourself especially;

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  • Surely if politicians are correct and people are indeed desperate for routine services at weekends, uptake would be immediate and then fall off (as those who won't make time to attend during the week present and have their problems sorted)? If uptake "improves" with time, one explanation would be that there is no genuine need for it but if presented as an option, eventually people stop giving their health care the importance it deserves by making the effort to attend during normal hours and turn up instead when there is nothing else to take priority over their health. We should have enough professional self-respect not to let general practice be debased in this way.

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