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Independents' Day

Half of PM’s seven-day GP access pilots have cut opening hours

Exclusive The Prime Minister’s flagship scheme to extend GP access appears to be rapidly running out of steam, with almost half of pilots reducing opening hours and local GP leaders citing lack of demand.

A year after the Prime Minister pledged that all patients would have access to a seven-day GP service – from 8am to 8pm - by 2020, a Pulse investigation has revealed that, of the 18 pilots that were given funding in April 2014 to offer seven-day access, eight in total have now either cut weekend or evening hours, or stopped providing the service altogether.

The initial funding for the scheme, worth £50m, runs out this month and NHS England and the CCGs involved in the pilots are remaining tight-lipped about whether the schemes will continue. But Pulse has learned seven-day access schemes across the country have been cut:

  • In Devon, the Devon Doctors Group running part of the pilot in south-west England told Pulse that its four 9am to 5pm Saturday and Sunday appointment sites were ‘no longer in operation’.
  • NHS Slough CCG said that its Challenge Fund pilot has reduced weekend access to four hours on Saturday and Sunday, having originally offered 9am to 5pm on both days.
  • In Derbyshire, there are still two seven-day hubs, but they have cut hours from four hours to two hours on weekdays, and 12 hours a day to just three hours at weekends. The CCG told Pulse funding for the reduced service will continue until March, after which seven-day access will be provided through its ‘vanguard’ GP partnership.
  • A number of practices in north-west London have cut hours for their seven-day access pilot being run across five CCGs. A spokesperson for the CCGs said the CCGs as a whole are providing seven-day access to ’many more patients’ since the start of the pilot.  

This is in addition to four other schemes that reported doing so earlier in the year due to the pilots proving ‘unpopular with patients’, meaning almost half of all pilots have scaled back their ambitions before the pilots end.

Local LMC leaders say the reason for the cuts is little appetite for seven-day services among patients. A spokesperson from Londonwide LMCs told Pulse: ‘The CCGs have found that weekend opening is not as popular as first thought, so weekend hours covered have been modified.’

Dr John Ashcroft, executive officer at Derbyshire LMC, says his local pilots have taken money away from existing services and bemused patients. He says: ‘It may tick the seven-day access box for managers and the Department of Health, but has made little difference to patients – except confusing them with initiatives that are not joined up.’

An NHS England spokesperson said: ‘A national evaluation of the programme will be published with more information on each of the pilot.

PM’s seven-day pilots question wisdom of seven-day opening

Readers' comments (11)

  • Vinci Ho

    I stick to my opinion all the time: invest the £50 millions into existing out of hour service and charge a fee (which should be claimed back from employers ) if routine appointments are to be available in weekends .

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  • The smug expression on his face of the 'Audi phenomenon'
    3 years ago, I bought an Audi A 1. Within weeks, I was back at the dealership due to ridiculously low mileage and a flashing 'particulate filter fault' signal which continued for three years during which I was in and out and the checks revealed no problem.
    The Sheffield office of Audi issued a letter to all A1 owners that there was a software problem causing particulate filter problems but the dealership still ignored this and denied any problems.
    Now, we know there was a software problem - intentional and malicious- to cheat on emissions.
    Looking at the state of denial in which Cameron and Hunt have sunk, I hope they wake up and agree that there is a problem and they've got it all wrong before the Electorate takes them to task akin to what the car manufacturers now face. Future generations won't forgive them for this mess, I hope.

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  • Maybe now we can concentrate on putting funding into core hour services and making them fit for purpose? There is so much variation in the productivity of practices during core hours. I don't know how CCG's have managed to effectively identify un met demand and then plan appropriate services for weekends and 7-day working. I am not surprised by these findings.

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  • Ivan Benett

    It is really unfortunate, not to say irritating, that Pulse can't get it's facts right and seems to wish to pander to negativity of their readership.
    First of all the CCG is not paying people to do these sessions, and did not set the pay scale. The GP federation is. Actually I think the GP Provider Federation have pithced the price at about the right level.
    Secondly, our pilot showed a 14% reduction in A&E attendances, not 3% as reported. We did not impact on unplanned admissions, but the pilot was not set up to do so.
    We need whole system change to coordinate Primary and Secondary Care to reduce unmplanned admissions and through other schemes may be begining to achieve this (it's early days). It is a separate initiative, which builds on and incorporates extending hours. The so called 'First Response' initiave.
    Again, no-one would ever earn what Peter Graves [mischievously] suggests as there aren't sufficient extended hours in a week to work the exquivalant of full time (37.5hrs) face to face patient contact.
    Extended hours payments take into account unsocial hours and local pay scales.
    It is normal for demand to fluctuate during the week, and over the seasons. We've just been through May June July August and September. Let's see what happens over winter before dismissing extended hours as part of the solution.
    Finally, the prupose of extended hours, as well as seeing patients that need same day access (but can't get it through their practices), is to be able to allow people who can't get to their GP during normal working hours. People who work, or have carers who work, or have other responsibilities.
    Finally finally, GPC have just published a paper asking for more capacity in GP, greater investment, and better responsiveness to patient need. Extended hours delivers on exactly these. It is also a platform for doing so much more in Primary such as diagnostics, some secondary care activity, multidisciplinary team work. These initiatives will release more activity from acute trusts and support further investment in Primary Care. It's a shame Pulse journalists can't see this
    So, we need more money [YES]. We need more doctors and nurses [YES]. So lets make the case and put it to the Government in a sensible way. I notice that some are discussing resignation - Really?? Again??

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  • Ivan does you pilot not just show that OOH is underesourced?
    Surely having appointments on a sunday would only help a/e visits if they are urgent appointments, not routine, in which case OOH could deal with them?

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  • It's people like you at the minor rungs of the leadership helm Dr Bennett (with political aspirations no doubt) that have made me glad to get out of working in NHS general practice, You continue to push on and on about extended hours but let's get the time and resources in the hours we are trying to work first; , all you are doing is helping to foster a culture that an overextended elastic band can be stretched even further without breaking when it is already snapping in some areas,

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  • Extended hours enable politicians and DOH mandarins see a GP outside of their working hours. When they can't, they use A&E inappropriately.

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  • I see the Pioneer has resurfaced with more words of wisdom.

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  • Long past time to end this ridiculous scheme that is simply a non evidence based political vote seeking Wasteful nonsense
    If Ivan claims reduction in aed attendance clearly it is more cost effective to bolster out of hours rather than create a duplicate service encouraging inappropriate use of scarce human and financial resources when for years ooh services have been trying to educate otherwise
    Stop colluding with this pathetic unethical delusional nonsense dreamed up by an uneducated ignorant and totally out of touch psychopathic PM millionaire who has gloried in the brutal mistreatment of the disabled and the nhs

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  • Routine appointments at the weekend- balls. I want work done at a weekend then I have to pay a premium. The NHS jam is spread too thin and Cameron's fund itn't new money, it's the money that should be in the NHS anyway as they haven't paid increases at a level to keep up with expenses.
    I have to take time off to see dentist, solicitor, bank manager and my GP- so should everyone else- if not pay a bloody big premium.
    Ivan and his mates can earn it if they wish but it's unworkable where you cannot fill posts for regular GPs let alone OOH and extended hours.

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