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PM's seven-day GP pilot drastically reduces Sunday opening amid 'frequently empty' appointments

Exclusive A pilot given £1m by the Prime Minister’s fund to increase weekend access has already scrapped Sunday appointments due to a lack of demand, Pulse can reveal.

Although the pilot in Hertfordshire and the south Midlands was aimed at offering GP appointments from 8am to 8pm seven days a week, Pulse can reveal that the the pilot has drastically reduced Sunday opening times following ‘an assessment of appointment utilisation’.

The news comes just days after Prime Minister David Cameron renewed his pledge to extend NHS access across seven days, starting with GP services.

Pulse has previously revealed that NHS Canterbury and Coastal CCG had dropped their pilot, funded by winter money, after it failed to reduce hospital pressures.

But this is the first known example of a so-called ‘Challenge Fund’ pilot cutting back on weekend access, as NHS England has extended the funding to the first-wave GP access pilots to allow for a ‘fuller analysis.

The Watford Care Alliance, formed by 11 practices, has been offering seven-day opening jointly via two hub practices, commissioned by NHS Herts Valley CCG, after being selected for the first wave of the Prime Ministers’ GP seven-day access pilots.

According to CCG papers, the area received £794,620 from the £50 million fund, which it said would pay for an extra 16,000 GP appointments per year.

But speaking at the LMCs Conference in London last week, Hertfordshire LMC vice chair Dr Sarah Khan said that the appointments on Sundays had been ‘frequently empty’ and they had therefore been cut.

She said: ‘In our patch Hertfordshire we have had the Prime Minister’s Challenge Fund pilots. Despite the pressures and despite an excellent out-of-hours service and widespread extended hours, GPs in my area have been providing 8-8 appointments seven days a week.

‘And guess what? The appointments on Sundays would be frequently empty, to the extent that they are now no longer being provided.

Di Pegg, head of primary care for NHS England in Central Midlands, told Pulse: ‘Patients in Hertfordshire are able to book Sunday appointments between 9am and 1pm and these can be accessed either by making an appointment or calling to NHS 111.

‘These appointments are popular with patients and there are no plans to discontinue them, though recently the hours on Sundays were reduced from 8am to 8pm following an assessment of appointment utilisation with the aim of making the pilot service more sustainable in the longer term.’

The scheme was highlighted as a success by NHS England earlier this year, when a spokesperson told Pulse that ‘in Watford, the local patient survey reports that 16% of patients would have accessed A&E or out-of-hours provision if the extended hours service wasn’t open’.

But, according to Dr Khan, the Government’s seven-day access plans were ‘a risk to patient safety’ as it ‘spreads GPs too thinly’.

Her sentiment mirrored that of GPC chair Dr Chaand Nagpaul, who in an emotive speech to the LMCs Conference told politicians that they must ‘jettison pipe dreams’ of seven-day access.

NHS England announced the expansion of seven-day opening pilots to 1,400 more GP practices in March this year after the Government announced a £100 million second wave of funding last autumn.

Readers' comments (16)

  • ''The Watford Care Alliance, formed by 11 practices, has been offering seven-day opening jointly via two hub practices.........''

    If you provide 7 day access in hub practices - by the time all patients come to know about this service will take 7yrs.

    7 day service, if implemented, so be provided by the respective surgeries only and this should be appropriately funded. Otherwise, it will be a waste of time.

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  • "7 day service, if implemented, so be provided by the respective surgeries only and this should be appropriately funded"

    This really wouldn't work. Demand is low (as in the story) and so you'd have practices opening up for 30 mins to provide a few appointments on a sunday.

    This is unnecessary to begin with but if it has to be provided it can only be via aggregating appointments in a couple of locations

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  • The scheme was highlighted as a success by NHS England earlier this year, when a spokesperson told Pulse that ‘in Watford, the local patient survey reports that 16% of patients would have accessed A&E or out-of-hours provision if the extended hours service wasn’t open’.

    Clearly this does not even approach the lowest classes of evidence for clinical study.

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  • OOH care is over subscribed . Especially on Sundays . It's lack of advertising - take out 2 x 15 second adverts during Corrie and you'll have plenty of customers - if you want them .

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  • Anon@11.06
    Or just use the funding for OOH given that the point is supposed to be to reduce A&E attendances and routine 7 day opening is detrimental to general practice

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  • Vinci Ho

    David Cameron was huffing and puffing about how much he hated Jean-Claude Juncker to become the president of EU commission. Then the reality bites in , look what he had to do now . Somebody said it was 'clever' for him to promise a EU referendum before the election because it meant Tories could avoid the debate of what his party really stood for. This could have secured some of the votes.
    7 days opening only in GP hubs is the furthest you can go considering how much money you can provide and how many doctors you can recruit and retain. Better investment and IT links in OOH service to provide some so called 'routine' appointments for the weekend , is lot more logical. Otherwise , if one really wants to push this so hard for the weekend appointments, patients should pay for a fee/
    Yes, you have just won the general election but it does not necessarily mean you won the argument , Mr Vader.

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  • I think the words I used were "frequently empty" rather than "completely empty".
    I'd be grateful if that could be corrected.
    Of note- phlebotomy was popular on a Sunday. (Which is something that phlebotomists do, not GPs.)
    Thanks.

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  • Thanks Dr Khan - that has been changed

  • Lets see,

    Per week, 1.5hr (weekday) x5 + 12hrs x2 (weekends) = 31.5 hours/week
    In a year 52 x 31.5 = 1638 hours needed to be funded for extended access.

    Total fund £794,620
    fund per hour provided £485

    WTF? These guys are spending £485/hour to provide this service?? From number of appointments offered at 16000/year, it looks like 2 GPs were employed to offer 8000 apointments each. (assuming you can recruit a GP) This amount of money will easily fund 4 full time partners every hour!

    What a waste........

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  • Are phlebotomists happy to work7/7?

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  • Maybe we can get the GP's to do some phlebotomy whilst they're there twiddling thumbs?? after all this is about what the patients want and the customer is always right??

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  • You might want to remember patients are not customers.

    If they were, I'll be a lot richer as I will find ways of making money out of customer in consumeristic health care.

    Thankfully, I quite like having patients rather then customers so I don't extort them for my personal gain. That includes being paid GP locum money to do phlebotomy work.

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  • @7:31pm
    there was a hint of sarcasm in the previous comment;

    when I was a youn trainee on the vts only a few years ago I remember working in A&E and they referred to the department as "the shop floor", patients were routinely referred to as "customers" by staff (of the cuff comments I know.. such as "we have a customer waiting in bed 6")........all part of the plan I guess to turn us into 24/7 "mcdonalds" medicine!!

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  • And what is the point of being able to provide Phlebotomy on a Sunday? The labs are not open to take the samples even if we could get them collected and delivered. We already provide 7 days a week opening but using the OOH system. Its all just political sound bites that make it look as though the patients are getting something new. We used to open on Saturday mornings 10 years ago. This was also abandoned through lack of patient demand. The sentiment "frequently empty" has a familiar ring to it. Just like most Political sound bites.

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  • not surprising..at all..........
    the 7 day opening is ludicrous; discourages patient self care and is a criminal waste of nhs money desperately needed elsewhere to fund genuine need.
    frankly it is an utterly moronic piece of craven vote chasing which the profession should have no truck with.
    not surprising..no other health system operates a 7 day minor illness service..as all other countries possess an iota of common sense.
    i really wish our once honourable profession would no longer endlessly prostitute itself for the endless insane pieces of political garbage like this.

    we should all learn to say NO;behave as true professionals and only do scientifically evaluated interventions...any other action is always immoral..like practising homeopathy when it is known to be absolute nonsense....nonsense is nonsense and always damages patient care globally by wasting resources and creating false priorities.
    if we all had ......the profession and the nhs would be in far far better shape.
    we as gps also need a revolution in our leadership..united behind medical science we would have support from the public and humiliate the political pygmies we are infested with.

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  • There is probably a merit in thinking about a Primary Care Service 7 days per week. The fact is that it does already exist and it is by far more challenging to find a Dentist, to name just an NHS professional, than a GP on weekends - and not only. Perhaps some weekend GP surgery appointment have been even prebooked to make the numbers...But, you cannot forget the following: If demand remains unchanged and supply increases (supply curve shifts to the right), a surplus occurs, leading to a lower equilibrium price....Price, in this case, is the time the patient will be willing to wait in the future...Be mindful that having removed something is always far more painful than enjoyable may be to have been given the same.

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  • To other health professional 26/5/15 7:16 pm.
    And perhaps you would be so kind as to do my job. And please remember, you would not have me to seek advice from, I am busy taking bloods whilst you are now twiddling your thumbs. LOL, one has to laugh at your innocence.

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