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Majority of GPs say Government's extended access strategy will harm patient safety

Exclusive More than half of GPs believe that the Government’s move towards seven-day GP access will negatively affect the safety of patient care, a Pulse survey has revealed.

The survey of 431 GPs found that 58% believed that seven-day GP access will impact the safety of patient care ‘negatively or very negatively’, as opposed to 17% who said it affected care ‘positively or very positively’. Some 68% also said they would not support a move towards seven-day GP access even if it was properly resourced.

This comes as a blow to the Government’s push for extended access, which this month saw the announcement of a series of new schemes funded through £50m of central Government money, involving more than 1,000 GP practices piloting such initiatives as 24-hour telephone access and weekend surgeries for working people. 

GPs and leading academics have already warned that the extended access strategy will make general practice more overstretched and could subsequently reduce the continuity of patient care.

Pulse reported last week that NHS Central Manchester CCG has claimed its extended hours scheme has reduced unnecessary A&E attendance by a quarter in three months.

But respondents to the survey warned that secondary care services will not be fully available if seven-day access is rolled out nationwide and it will reduce continuity of care.

Dr John Stanger, a GP in Cambridgeshire, said: ‘I’ve no doubt that seven-day access will reduce continuity; it can’t be otherwise unless we are all meant to work seven-day weeks. Will safety get worse? Probably. Partly due to lack of continuity, doctors may well become more tired, and will full secondary care services like laboratory and radiology also be available seven days a week?’

GPC deputy chair Dr Richard Vautrey said patient safety will be affected and that the initiative is a ‘pre-election scheme’. 

He said: ‘Patient safety will be compromised if patients are treated by increasingly tired doctors who don’t really know them. In addition, stretching an already overstretched service more thinly to cover a greater number of hours will break the core service and again reduce the quality of care patients receive and further undermine the recruitment and retention of GPs. 

‘In order to maintain and enhance patient safety we need more GPs and more time to deal with patients who present with complex problems. That requires sustained year-on-year increases in resources, not just a one-off pre-election scheme.’ 

An NHS England spokesperson said: ‘The key aim of the PM Challenge Fund is to improve access to services and stimulate innovative ways of providing primary care. This will result in all practices benefiting from shared learning and development, and spread innovation.

‘The additional sessions will be offered in a range of ways that doesn’t necessarily require additional staff. In some cases GP time will be used in “smarter” ways that free up time for seeing more patients, and for other members of the healthcare team to see patients where this is appropriate. In other cases additional staff may be employed through a range of local arrangements but it is part of a wider project to deliver services differently.

‘The funding is designed to enable practices to develop sustainable ways of reshaping services for the future, so that improved access becomes the norm.’

Survey results, in full

 

How do you think that seven-day GP access will affect the safety of patient care?

Very negatively: 19%

Negatively: 39%

Don’t know: 25%

Positively: 15%

Very positively: 2%

 

Would you support a move towards seven-day GP access in your practice if it was adequately funded?

Yes: 22%

No: 67%

Don’t know: 11%

 

About the survey: Pulse launched this survey of readers on 15 April 2014, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey.

As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. These questions were answered by 434 GPs.

Readers' comments (14)

  • Vinci Ho

    Anyone wants to guess who is this NHS England spokesperson ?

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  • It makes my heart sink when some beurocrat tells us to work smarter usually they do little if any front line work and have a poets day on a Friday.When someone comes out with this type of statment it usually means they are full of bull.

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  • extending hours will adversely impact continuity, which is unsatisfactory and frustrating for GPs and patients. I have first hand experience of the system, which involves inadequate resources being available as they are spread out, and as funding becomes an issue, are reduced further. Without a doubt, compromises safety.
    Unless all healthcare resources ie lab testing etc are available, then extending hours has limited benefit apart from true minor illness, but then why not self-care or see a Pharmacist?!

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  • so we can work 'smarter' . We are fully aware of the limitations and medicolegal pitfalls of e-mail/telephone and now skype consultations. We just need more GP's and less NHS England/Political medling. Simples.

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  • Somehow DOH seems to think that a Skype consultation takes less time than a face to face one. Genius.

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  • How it will affect patients safety. So does it mean that Hospitals also have to close at week-ends.

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  • "How it will affect patients safety. So does it mean that Hospitals also have to close at week-ends."

    The information is in the article. There aren't enough GPs, and whilst the Consultant body has seen a huge expansion over the past decades there has been no such increase in GP numbers. So the same number of GPs would be either doing more work (tired doctors) or having to reduce capacity during the day (because they'd worked in the evening).

    GPs are not governed by the EWTD like many/most hospital staff and so this will affect patient care and safety.

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  • Bob Hodges

    'Work Smarter' is the refrain of idiots.

    I've never been encouraged to 'Work Smarter' by anyone who's actually 'smarter' than me.

    If someone is actually 'smarter' than us, it would be safe to assume that they would be 'smart' enough NOT to be working for DoH, NHSE or a political party.

    Really clever people do other things.

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  • There is only one solution to this government's mindset of changing the ethos of General Practice in this country.
    DO NOT VOTE TORY AND PUT UP WITH THEIR MINDSET/ MENTALITY TO SEE THE DEATH OF GENERAL PRACTICE IN NEXT 5 YRS OF TORY!
    5 YEARS ON WE WILL SEE GPS WORKING IN PREMISES WITH DOMINOS PIZZA OR 24HR TESCO EXPRESS. THIS IS CALL INNOVATION ACCORDING NHS ENGLAND AND MR HUNT.

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  • mmm Pizza...

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