£250m-a-year GP extended access scheme had ‘no measurable impact’, finds study

The Government’s flagship GP extended access scheme, which costs an estimated £250m a year, had ‘no measurable impact’ on patient access to appointments, a new study has found.

Led by the University of Manchester, the study also reported no notable impact on continuity of care or overall patient satisfaction with general practice.

The scheme was first introduced in 2016 – after the Conservative Party pledged evening and weekend GP appointments in its 2015 manifesto – with CCGs in England told to commission and fund the services to help address declining patient satisfaction.

By 2017/18 half of England could access these services in the evenings or on weekends, with a target set to introduce the services across the whole country by October 2018.

While there was evidence to suggest the scheme has reduced admissions to emergency departments, the researchers said there was little research into how it helped GP patients.

The new paper, published yesterday (22 February) in the BJGP Open, assessed the impact on patients across more than 5,800 GP practices, using data routinely collected by NHS England on the number of days and type of extended access offered from 2016 to September 2018.

This was then compared to responses from the 2018/19 General Practice Patient Survey (GPPS), focusing on how satisfied patients were with appointment times, access to a preferred GP, and overall experience.

The study concluded that while extended access may benefit some demographics, they failed to find any significant benefit for the general population.

The paper’s authors said: ‘We found no evidence of a statistically significant association between extended access provision and any of the practice measures.’

This is despite estimates suggesting that the NHS spent somewhere in the region of £250m on providing these services in 2018/19.

They added that evidence indicated some external extended access appointments were either left unfilled or were being used as overspill ‘because there were not enough day time appointments’.

The authors did note, however, that the data is dated from a period when there were ‘considerable differences’ in the provision of extended access services, but that their modelling accounted for these.

In 2019, NHS England said that seven-day access would be reviewed to make sure it is ‘sensible’ for practices, as part of the move to primary care networks.

Similarly, with the pandemic leading a greater number of patients to take advantage of remote consultations, the authors questioned ‘whether there is now as much demand for access to appointments outside of the regular working day.’

NHSE has been contacted for comment.

Meanwhile, the Institute of General Practice Management (IGPM) said that it supports the continuation of the scheme.

It said: ‘We understand that usage of the extended hours appointment slots is varied across GP surgeries and used dependant on need and demand. However, we feel it is important that we offer patients a variety of ways to access healthcare whether that is face-to-face, telephone or video consultations.

‘Having access to GP and nursing time out of core hours is hugely helpful to patients who can often manage their routine health needs at a time that fits in with their busy lives.’

Pulse previously reported that around 25% of evening and weekend appointments were being left unfilled as the policy was being rolled out nationwide.

A version of this article was first published by Pulse’s sister title Management in Practice