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A faulty production line

Flagship seven-day GP access scheme extended after showing 3% decrease in A&E attendance

The seven-day pilot held up by the Prime Minister as a blueprint for extended GP access will be extended as an official evaluation has shown it reduced A&E attendances by 3%, but had little effect on patient satisfaction.

The figures from a DH-commissioned analysis of the pilots have been unveiled by the parties behind the Greater Manchester health devolution project, as it formally announced plans to roll out seven-day access across the entire region.

The evaluation by the National Institute for Health Research (NIHR) into the £2 million ‘demonstrator’ pilots funded by NHS England in Greater Manchester also revealed that only one of the four sites had reduced minor A&E attendances.

It also concluded that seven-day access schemes ‘will not necessarily substitute existing services’.

The evaluation results come almost two years after Prime Minister David Cameron accidentally declared the pilots ‘a success’ before they had even started upon unveiling the first wave of the ‘Challenge Fund’ seven-day access pilots.

The evaluation found:

  • one of the pilot sites, run by NHS Central Manchester CCG, recording an 8% reduction in ‘minor’ A&E attendance, equating to an A&E cost decrease of £425,000;
  • two of the sites - Bury and Middleton - reduced overall A&E attendances by 4% and 3% respectively;
  • the overall reduction in A&E attendances in all the regions was 3%.

However, it also found little impact on patient satisfaction.

The report said: ‘[T]here was some evidence that satisfaction improved among patients at demonstrator practices compared to the rest of Greater Manchester, however, very few statistically-significant results were observed… With the exception of Bury, there does not appear to have been a consistent impact on patient satisfaction in terms of access to general practice.’

The scheme saw four out of six pilot sites offering evening and weekend GP surgeries via ‘hub’ locations to some 300,000 patients from 2013.

According to the Manchester devolution programme board joint chair Sir Howard Bernstein, this evaluation underpins the move to roll out seven-day GP access across Greater Manchester, having helped it to ‘gain insight into what helps both patients and doctors’. According to Sir Howard, the move ‘has the potential to transform health outcomes for the region’.

NHS England chief executive Simon Stevens said the ‘welcome ambition’ to expand seven-day access ‘shows how devolution can produce world gains for patients’.

The expansion plans also received LMC support, with Manchester LMC chair Dr Tracey Vell commenting: ‘It’s commissioned and funded separately, which means individual practices are not overwhelmed, making workload pressures worse.

‘We’re happy to support it in this form and hope to continue to represent the views of the GP workforce as the plans fully develop this year.’

As previously reported, the plans to set up seven-day GP access hubs across all of Greater Manchester is a precursor for plans to also begin to offer a wider range of community and social care services via the hubs.

The pilot in Manchester is seen as a test bed for the PM’s ambition to roll out seven-day GP access to the whole of England by 2020. However, GP leaders have called it a political ‘pipedream’ as Pulse revealed CCGs in some areas of the country are rethinking their extended access plans due to lack of demand and cost-effectiveness.

This article was updated at 14:30 on 10 June 2015.



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Readers' comments (67)

  • Ivan Benett

    This is an excellent finding for the people of Greater Manchester and for the GPs of Greater Manchester. Sustained funding to role out the programme to be delivered most likely by GP federations, will allow a springboard for greater integration of out-of-hospital services, care services and so support increasing investment into Primary Care. GPs will be able to work more flexibly, have portfolio careers, and pursue special interests if they wish. This in turn will provide a positive incentive for young doctors in Greater Manchester and across the country to take up GP as a career choice.
    Oh, and patients like it. People who work, have carers who work or are in full time education will have greater opportunity to access the NHS for their needs. Reducing unmet need is a key aim of better access. Finally, increasing capacity in Primary Care will take pressure off the fluctuations in urgent care demand on practices and allow us to begin to focus on LTC management and proactive admissions avoidance. Once we can get into that virtuous cycle of prevention, reducing admissions and reinvestment in services, then we will have truly turned a corner in the NHS and Social Care system. It is also great to have LMC support for taking this forward. I hope we will be able to report further successes as this new system of working beds in.

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  • 3% wow

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  • younger doctors are looking for a way out Ivan.

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  • sorry 2 million pounds spent has saved how much?

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  • I'd like to see the data for this.

    Is 3% significant (as in statistically)?

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  • £2,000,000 spent
    £425,000 saved
    You don't need to be Carol Vauderman to do the maths!

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  • Seriously, Ivan. Please stop this your ideological spin- you may soon start having vertigo.
    3% of what - 10,000? 100,000? At what cost? Could this money have been invested elsewhere with better outcome. Is the 3% statistically significant?
    It will be interesting to see the actual report and see how the 3% was derived.

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  • They spent £2 million to save a few hundred thousand at the best!
    One one hand Ivan is a genius who has conned the politicians to part with money for snake oil, on the other hand he is an fool as now the government will expect other GP`s to do same for free.
    Only time will tell.
    LMC says its OK as its separately funded (Ivan should read the LMC statement between the lines)

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  • The problem with medicine is that it is controlled by a small number of dominant "masters" who lecture the rest of us based on no more knowledge or expertise than we have ourselves.....personally I cannot overestimate my insult at being lectured to by these self-appointed experts.
    Why can't they just go away and find somebody else to lecture??

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  • Lack of savings a side, didn't it leak of corruption and tampered evaluation? Seems to me "success" of this project was written down in stone 2 years ago.

    I wonder what political ladder those leading this project will climb now they've saved David Cameron from political embarrassment

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