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Seven-day GP access pioneer hails cut in unnecessary A&E attendance

Exclusive The leader of a seven-day working pilot lauded by the Government has claimed the scheme has cut the number of unnecessary A&E attendances by more than a quarter in three months.

An early evaluation of the pilot scheme run by NHS Central Manchester CCG also found that the number of patients who said they attended A&E because they were unable to get a GP appointment had ‘halved’, the CCG clinical director Dr Ivan Benett told Pulse.

However, local leaders have said that extending access should not be a priority and warned these extra appointments do not receive the full clinical support available in hours.

Thie evaluation results follow the Government’s announcement last week of £50m worth of funding for 20 schemes across England to pilot extended hours access for one year.

The Central Manchester pilot, which was one of six in the north west of England was mistakenly hailed a success by the DH before it had actually begun.

The six schemes together received £2m worth of ‘winter money’ from NHS England’s local area team to reduce pressure on emergency services, and saw GP practices in four locations work in hubs to provide access from 8am to 8pm on weekdays, and between 8am and 6pm on Saturday and Sundays.

Dr Benett said the CCG now thinks that the project could become ‘self-funding’ because of the reduction it has achieved in hospital pressures.

He said: ‘We estimate this have led to a reduction of 27% in primary care attendance at Central Manchester University Hospitals  NHS Foundation Trust A&E compared to last year. There has also been a reduction of 50% of people turning up to A&E saying they are because they could not get an appointment with their GP.’

He added: ‘I’m confident that the extended hours will provide a better service and reduce urgent care activity so it will be self-funding.’

But Dr Tracey Vell, medical secretary of Manchester LMC and a GP in central Manchester, said there were concerns with the pilot locally.

She said it was a ‘duplication of current GP out-of-hours services’, adding: ‘We do not feel that routine appointments at these times are fully supported with pathology and other investigations.’

‘Politically, we feel that access for our patients is already great and that money could be spent on other projects.’

Last week, Pulse reported that the Government has not committed to continue to fund its nationwide scheme beyond next April, instead hoping they can prove self-sustainable and be carried forward commissioned by CCGs.

However, Dr Paul Charlson, who is the vice-chair of Conservative Health and a GP in Brough, East Yorkshire, said that a nationwide push for extended access remains at the heart of discussion within Tory circles ahead of next year’s election.

He said: ‘It is such a hot issue with the public that understandably the Government is keen to pick it up and encourage it. Whether that is by carrot or stick depends on a number of factors - one being GP recruitment.’

Dr Charlson added: ‘I personally would like to see a situation where there is a minimum number of face-to-face consultations per week based on list size, which I know has been talked about. This appears fair as there is significant variation in this across England which is not wholly explained by demographics.’

Asked about future plans for extending GP access, the DH said it would be ‘inappropriate to comment’ before next year’s GP contract negotiations had begun.

Pulse reported last week that experts have warned that stretching access over seven days threatened to hamper continuity of care and derail the health secretary’s bid to improve care of vulnerable elderly patients.

Related images

  • Dr Ivan Benett - online
  • Taken from issue
  • Dr Tracey Vell 330x330 online

Readers' comments (48)

  • The govt had already decided it was a success!
    They were never really going to report failure were they!

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  • Perhaps I am being stupid - all that has happened is that these patients are seeing a GP doctor instead of a AE doctor. It doesnt prove that that what was an unnecessary AE consultation was a necessary GP consultation. Its just pandering to impossibe patient demand.

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  • 'claiming' and hard data are two different things.

    let's wait until the evidence is presented (if it ever is)

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  • "Its just pandering to impossibe patient demand."

    This is exactly the problem. Unfortunately the CCG will be happy (if the above is to be believed) because GPs pandering to inappropriate demand is cheaper than A+E pandering to it.

    The first poster is also completely correct. Since this was deemed a success before it had started, is anyone surprised about this "result".

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  • The peaks in A&E attendances seem to be in hours and concentrated Monday to Thursday.
    Has this Pilot reduced these attendances, and if so, has anyone looked at the changes in patterns?

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  • I feel this smacks of the Tesco 24 hour mentality! Why on earth would I go to Tesco at 3am? oh I know why, because I can!

    We have the data to prove who fills our late opening slots, and anyone hazard a guess?

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  • Hard figures would be useful

    "He said: ‘We estimate this have led to a reduction of 27% in primary care attendance at Central Manchester University Hospitals NHS Foundation Trust A&E compared to last year."

    3 instead of 4?

    "There has also been a reduction of 50% of people turning up to A&E saying they are because they could not get an appointment with their GP."

    1 instead of 2?

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  • I agree with anon@10.03
    Why applaud increased GP workload when we are already struggling? Where are the schemes to cut unnecessary GP attendance?

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  • Bob Hodges

    anon 11:26

    Exactly!!

    If 30% of attendee didn't did to go to A&E - what proportion of those didn't need to go to a GP either?

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  • ".. the number of patients who said they attended A&E because they were unable to get a GP appointment had ‘halved’.."

    Presumably the time of attendance and reason "unable" to get a GP appointment was recorded to allow proper analysis before any conclusions can be drawn.
    Opening for longer hours (with ultimately fewer GPs as a likely result of this policy) is not necessarily the solution - opening for the same hours with more GPs and hence more appointments might be at least as effective but lacks headline-grabbing appeal.
    We need a definition for "unnecessary" A&E attendance and to know what proportion were deemed "necessary" GP consultations

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