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At the heart of general practice since 1960

'Seven-day access fairytale is not deliverable'

More than 100 GPs have signed a letter to the Prime Minister calling his pledge to provide seven day GP access from eight till eight if the Conservatives win the next election a ‘fairy tale’.

Mr Cameron,

I listened with interest this morning to your political sound biting on your General Practice vision for 8-8 working, seven days a week.

To be honest, we had been expecting this baloney for some months as your pilots for the scheme draw to a close. What’s more interesting, is that having pump-primed these pilots with £50m (half of what you are offering to roll it out across the country), they have failed to deliver the reductions in A&E attendance or quality as promised.

More importantly, these beleaguered services actually struggled to find any GPs to provide the service, despite having big money to play with. Not surprisingly you brushed over the lack of evidence to show that these ill advised, vote winning policies actually brought benefit to a system that tries to match cost effectiveness against consumerist demand.

In your closing speech, you pledged more funds for the NHS. Let us remember, before the last election the Conservative party promised no reorganisation of the NHS. They failed to keep that promise. How can we be asked to believe that current election promises will be kept and where are all these GPs going to come from, to deliver this 24/7 service?

However, rather than try and argue those old chestnuts, perhaps we should just stick to the facts, although I appreciate politicians are not great fans of fact over fiction.

- The NHS costs £113bn per year
- Primary care currently uses 8% of the budget - remember here please that we are constantly being slated for being unable to provide an effective and timely service, even with this percentage and we are consistently pressing for at least 10% of the budget to sustain current levels of service.
- However, using 8%, the primary care budget is in the order of £9bn per year
- GP practices currently open 8-6.30 5 days a week or 52.5hrs
- If practices opened 8-8, seven days a week this would be 84 hrs or a 60% increase in hours per week

You have pledged an extra £100m for this increase in hours. This equates to 1.1% increase in Primary Care funding for a 60% increase in workload.

Do the maths, as your advisors obviously can’t! Forget the rhetoric and the arguments about doctor salaries, this fairy tale is simply not deliverable.

Resilient GP

 

Dr Michelle Sinclair, GP Partner, Fleet, GU52 7US

Dr Hussain Gandhi. GP. Wellspring Surgery. Nottingham. NG3 3GG

Dr M Suresh, GP Principal, Woodsetton Medical Centre, B13 8QJ

Dr Alexis Manning, Sessional GP, CF11 0SF

Dr Nitika Silhi, Salaried GP, Lynwood Medical Centre, RM5 3QL

Dr Mark McCartney, Locum GP, SE Cornwall, PL12 6UR

Dr M Suresh, GP Principal, Woodsetton Medical Centre, B13 8QJ

Dr Freda Bhatti, GP, The Hollies Surgery, The Green, Gt. Bentley, Colchester, Essex, CO78PJ

Dr David Shore, General Practitioner, Rugby, CV230LU

Dr Iain Hotchkies, GP, Merseybank Surgery, M21 7NN

Dr Siobhan Brennan, GP Partner, ordsall health, m5 3ph

Dr Ranjan Pruthi, GP, phc mawney road, RM78NX

Dr O’Reilly, GP, Essex, Co78pj

Christopher Earnshaw, GP, Lever Chambers Centre for Health, BL11sq

Dr Hannah Gibbs, GP, St Paul’s Surgery, Winchester, SO22 5DD

Dr Hala Atkin, GP, Green lane, Cv3 6ea

Dr Alexis Manning, Sessional GP, CF11 0SF

Dr Noim Amin, G.P, BR1 3DR

Dr Prit Buttar, GP, Abingdon Surgery, OX14 3LB

Dr Rachel Blackman, GP, Hartley Corner Surgery, Blackwater, GU46 7TJ

Dr Rajesh Mahadevaiah, GP, Aylesham, CT3 3BB

Dr Howard Sunderland, GP Partner, Marple, Stockport, SK66AB

Dr Alan Woodall, GP Principal, Machynlleth, SY208EQ

Lorna Macgregor, GP, NHS Highland, PA318AE

Dr James Higgin, GP Principal, Downlands Medical Centre, BN26 6AE

Dr Bastiaan Kole, Free Lance GP, Fulham, SW6 4HS

Dr Pamini Ledchumykanthan, Sessional GP, Shepherds Bush, W12

Dr Vic Sivanesan, GP, Mansell Road Practice, UB69EN

Dr Natasha Collins, GP Partner, St Lukes Surgery, np11 5GX

Dr Alasdair Gallagher, GP, Oakley Medical Practice, Leeds, LS11 5HT

Dr Shivani Vinayak, Gp, Ne31 1nu

Dr Nicola Waldman, Gp principal, Merton medical Practice, London, SW19 1DG

Dr Rhianna McClymont, GP, London, NW62HJ

Dr R Adam, GP, Hounslow, Tw135jg

Dr Lynette Saunders, Salaried GP, Wantage, Oxfordshire, Ox12

Dr Rachel Ali, GP Registrar, Plymouth, pl4 6px

Dr Catherine Jones, GP, Lighthouse Practice, Eastbourne, Bn21 4hy

Dr Sukhdip Jhaj, GP, Silsden and Steeton Medical Practice, BD20 0DG

Dr Lynette Saunders, Salaries GP, Wantage, Oxfordshire, OX12

Dr Sagar dhanani, GP HILLINGDON, Ub77dp

Dr Ross wentworth, GP, Poplars medical centre swinton, m27 0na

Dr Alixe Thiagarasah, GP, N211rn

Dr Murali Nair

Dr Samir Dawlatly, GP, Jiggins Lane Medical Centre, B32 3LE

Dr Dave Jones, GP, locum, M32 9AE

Dr Alison Lawton, Salaried GP, Park View Medical Centre, Long Eaton, NG10 3RJ

Dr Rob Mawdsley, Dr, Bridge of Earn, PH2 0PQ

Dr Thirza Deboo, GP, Marlborough, Sn8 4by

Dr Rebecca Gidley, Salaried GP, E1 0LS

Dr Alexandra Taylor, GP, Chatfield healthcare, Sw113uj

Dr Ashley Southall, GP Partner, Larksfield Surgery, SG5 4HB

Dr Tom Hodges-Hoyland, GP Partner, Ashgrove Surgery, CF37 2DR

Dr Sophia Galloway, GP, Steyning Health Centre, West Sussex, BN3 5ND

Dr Katherine Robertson, GP, Colinton surgery, Eh13 0LB

Dr Lenin Vellaturi, ST4 4QF

Dr Helen Phillips, GP, Burney Street Practice, SE10 8EX

Dr Yusuf Rajbee, GP partner, Portland Medical Centre, Se25 4qb

Dr Mei-Ling Lancashire, GP, Surrey, GU15

Dr Clare Dyer, GP, Baldwins lane, WD3 3LG

Dr Naylea Choudry, GP partner, Darwen health centre, Bb3 1py

Dr Robert Hegedus, GP Partner, Builth Wells, SA200YW

Dr Tabassum Ahmed, GP, Arnos Grove Medical Centre, N11 1BD

Amit Tiwari, GP, Mersea Island Surgery, CO5 8RA

Dr Nikki Prasad, GP, Ch medical, fields new road, West Didsbury, M202ED

Dr Shama Shaid, General Practitioner, Hemel Hempstead, Hp12ld

Dr A.Butt, GP, Sw4

Dr Tom Caldwell, GP Partner, Thorneloe Lodge Surgery, WR1 1RU

Dr Seema Haider, GP, Haiderian Medical Centre, Rm142yn

Dr Anna Morris, GP, Orchard Medical Practice, LE9 6RG

Dr Monah Mansoori, GP, TW1 2JU

Dr Dax Tennant, GP Partner, Polegate, BN245FH

Dr Jonathan Ferdinand, General Practitioner, Wickhambrook Surgery, Suffolk, CB8 8XU

Dr Sarah Worboys, GP, Nw52be

Dr Donagh O’Riordan, Consultant Physician, Colchester General Hospital, Colchester, Essex, CO4

Dr Rajeev Kanwar, gp, kineton, cv47 2qa

Dr Yogasakaran Arjuna, GP Principle, The Woodberry Practice, N21 3LE

Dr Victoria Ingham, Salaried Gp, Hawthorn medical centre, Swindon, Sn2 1uu

Dr Asha Pillai, GP Partner, Surrey, KT12 4HT

Dr Ben Williams, GP, Poplars Medical Centre Swinton, M270NA

Dr Jeremy Goad, GP Partner, Victoria Practice, Aldershot, GU11 1AY

Dr Russell Brown, GP, Manor Park Medical Centre, BN26 5DJ

Dr Anna Martin, GP, Queens Walk, W10 6HT

Dr Graham Hoggard, Pharmacist, Barnsley, S71 3qw

Dr David Barrett, GP Partner, The Old School Surgery, LE9 4LJ

Dr Alistair Richardson, GP, The village practice, N7 5JJ

Dr Nadim Azar, GP, The Glebe Practice, LN1 2NU

Dr John G Hughes, GP, M25 9GD

Dr Nasir Nabi, GP Trainer, Walker Medical Group, NE6 3BS

Dr Damian Fogarty, Consultant Nephrologist, Belfast Health & Social Care Trust, BT9 7AB

Dr Alison Johnston, GP, Ulverston Health Centre, LA12 7BT

Dr Jonathan Harte, GP, Aspley Medical Centre, NG8 5RU

Dr Kamal Sidhu, GP, Durham, TS27 4LQ

Dr Danielle Hann, GP partner, BD12 9NG

Dr Simionescu Ozana Maria, The Poplars Medical Centre, M27 0na

Dr David McLees, GP, Wallace House, SG14 1HZ

Dr C Patel, GP, London, sw66hx

Dr Zoe Neill, GP (soon to be ex) principal, Gibson Lane Practice, HG2 9PE

Dr Stewart Rutherfurd, General Practitioner, Morrab Surgery, Penzance, TR18 4EL

Dr Ruth Spencer, GP, 55 Hunter St, G4 0UP

Dr Amy Banks, GP, N1

Dr Colin Brunt, GP, Poplars Medical Centre, M27 0NA

Dr Paul Evans, GP Locum, North East England, DH1 4BE

Ian Davis, GP, Cirencester, gl77ey

Dr Michael Weymar, GP, Overseas

Dr Leena Menon, GP partner, Courthouse Medical Centre Caerphilly, CF83 8 NJ

Dr Teresa Tang, Villa Street Medical Centre, SE17 2EL

Dr Deborah Webb, GP, The Old School Surgery, Le9 4lh

Dr Lisa Griffiths-Brown, GP, South Wigston, LE18 4SE

Dr Catherine Lewis, GP Registrar, Hounslow, TW1 2AU

Dr Kirsty Shepherd, GP, Thw Wychwood Surgery, Shipton under Wychwood, GL7 3PH

Dr Ruth Marchant, GP, manorbrook medical center, SE3 0EN

Dr Brenda Moran, Salaried GP, Herne Hill Group Practice, SE24 9QP

Dr RJ Pinto-Wright, GP Partner, Ambrose Avenue Group Practice, CO3 4LN

Dr Karuna Sharma, GP, Richmond Surgery, Richmond Close, Fleet, GU52 7US

Dr William Gordon-Wright, GP, Horsham, DT6 6DA

Dr Sharif Hossain, GP Principal, Highcliffe Medical Practice, Higham, ME3 7DB

Dr P Bradbury, GP, Walkley House medical centre, S8 0BY

Dr Justin Ilott, gp partner, courthouse carphilly, cf83 3gh

Dr Bunmi Adeniji, GP, Windhill Green Medical Centre, Shipley, West Yorkshire, BD18 1QB

Dr Robert J White, GP, Westfield Surgery, TN35 4QE

Dr Tom Caldwell, WR37JW

Dr Paul Fitzgerald, GP, Minster Medical Practice, LN2 2JP

Dr Tesan Hadzikadunic, Cv34 6fs, United Kingdom

Dr Stephanie De Giorgio, GP Principal, Cedars Surgery, Deal, CT14 7DN, United Kingdom

Dr Carol Millington, M276HG, United Kingdom

Dr Eilish Davoren, DT6 5FD, United Kingdom

Dr Ian Bruce, G41 2AF, United Kingdom

Dr Nick Beedie, M47aj, United Kingdom

Dr Siobhan Stapleton, GP Partner, Mansell Road Practice, UB6 9EN

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Readers' comments (19)

  • Ivan Benett

    Our Central Manchester pilot has reduced Primary Care stream to A&E by about 14% during extended hours, compared to same time last year. Overall A&E attendances by almost 2% compared to last year - against a background of going up everywhere else.
    We've had no problems getting local GPs to do the extra sessions. No one has had to work more they they want to.
    One surgery covers 6-8 practices. Records are shared for continuity of care.
    So far over 7,000 people used the service. 1:4 say they would have gone to A&E. Nearly all found the service much more convenient for work, child care and other life activity.
    Yes it will take more resource invested in Primary Care, and I agree that we need to shift to 10-11% of NHS spend, and have a proactive recruitement strategy for GPs and nurses (complaining about how terrible GP is doen't help)
    I'd like to join the Resilience Group - How do I do it?

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  • Ivan I suspect they may have standards,may preclude you from joining!

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  • Ivan, how much did you get to deliver this and how many practices/patients did it cover?

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  • Ivan Benett

    Hi Nathen,
    The extra availability cost about 1/2 million for a year. It covers a popualtion of 212,000. That's about 32 practices. The extra availability is provided by a GP federation covering all Central Manchester practices. There are 4 localities (about 50,000 each) and 7-10 pratices each. It is unlikely to be self-funding (as you can see, and to continue will need the sort of resources we're talking about investing in Primary care. Once established it has the further potential to do planned care during those extended hours at marginal cost, as the premises already being used. So you can imagime doing LTC clinics, secondary care follow up clinics, diagnostics at more convenient times for patient and many more things.
    I believe, notwithstanding the strong feelings ecprssed inthese columns, that this is a great opportunity for Primary Care to do what we do best over a longer time during the day and week, and move more activity out of hospital. I know it's not popular with everyone, especially anonymous contributors in the early hours. I think if people see the opportunities rather than then down sides they will start to accept this as the way forward [YES as always, with the right amount of investment, a workforce strategy which may take 5 years, and an IT/IG strategy]
    Josh, I assume you are joshing rather than just being rude. It would be interesting to hear what those standards are?

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  • The key points for me are funding and the government's agenda - as per the letter they cannot be trusted, either to fund this properly or more importantly not to privatise the NHS

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  • Ivan, what did your scheme cost?

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  • Oops I see £0.5m for 212000 pts.
    People might be up for this if your level of resources were available nationally.

    It isn't and so they aren't.

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  • Azeem Majeed

    It would be very useful to see a formal evaluation of the extended access scheme that Dr Ivan Benett describes. In West London, local commissioners established an urgent care centre as the 'front-end' to the A & E Department in two hospitals. We are currently evaluating the scheme and will submit first paper for publication in the near future.

    You can read the protocol for the evaluation at http://goo.gl/sZFhs0

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  • So far over 7,000 people used the service. 1:4 say they would have gone to A&E. '

    Am I stupid but thats 285 quid per person not going to A+E if those figures are for a year.

    Pandering to voters will not get them to realise the NHS is valuable. Being able to see a GP about trivia on a Sunday imparts no sence of value.

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  • Erewash ccg had the greatest amount of dosh out priministers fund/head of population.
    Still hasn't delivered any 8-8, and start has been delayed another month and only 3 doctors down to work it.
    £1.2million well spent.

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