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Flagship seven-day GP access scheme extended after showing 3% decrease in A&E attendance



The seven-day pilot held up by the Prime Minister as a blueprint for extended GP access will be extended as an official evaluation has shown it reduced A&E attendances by 3%, but had little effect on patient satisfaction.

The figures from a DH-commissioned analysis of the pilots have been unveiled by the parties behind the Greater Manchester health devolution project, as it formally announced plans to roll out seven-day access across the entire region.

The evaluation by the National Institute for Health Research (NIHR) into the £2 million ‘demonstrator’ pilots funded by NHS England in Greater Manchester also revealed that only one of the four sites had reduced minor A&E attendances.

It also concluded that seven-day access schemes ‘will not necessarily substitute existing services’.

The evaluation results come almost two years after Prime Minister David Cameron accidentally declared the pilots ‘a success’ before they had even started upon unveiling the first wave of the ‘Challenge Fund’ seven-day access pilots.

The evaluation found:

  • one of the pilot sites, run by NHS Central Manchester CCG, recording an 8% reduction in ‘minor’ A&E attendance, equating to an A&E cost decrease of £425,000;
  • two of the sites – Bury and Middleton – reduced overall A&E attendances by 4% and 3% respectively;
  • the overall reduction in A&E attendances in all the regions was 3%.

However, it also found little impact on patient satisfaction.

The report said: ‘[T]here was some evidence that satisfaction improved among patients at demonstrator practices compared to the rest of Greater Manchester, however, very few statistically-significant results were observed… With the exception of Bury, there does not appear to have been a consistent impact on patient satisfaction in terms of access to general practice.’

The scheme saw four out of six pilot sites offering evening and weekend GP surgeries via ‘hub’ locations to some 300,000 patients from 2013.

According to the Manchester devolution programme board joint chair Sir Howard Bernstein, this evaluation underpins the move to roll out seven-day GP access across Greater Manchester, having helped it to ‘gain insight into what helps both patients and doctors’. According to Sir Howard, the move ‘has the potential to transform health outcomes for the region’.

NHS England chief executive Simon Stevens said the ‘welcome ambition’ to expand seven-day access ‘shows how devolution can produce world gains for patients’.

The expansion plans also received LMC support, with Manchester LMC chair Dr Tracey Vell commenting: ‘It’s commissioned and funded separately, which means individual practices are not overwhelmed, making workload pressures worse.

‘We’re happy to support it in this form and hope to continue to represent the views of the GP workforce as the plans fully develop this year.’

As previously reported, the plans to set up seven-day GP access hubs across all of Greater Manchester is a precursor for plans to also begin to offer a wider range of community and social care services via the hubs.

The pilot in Manchester is seen as a test bed for the PM’s ambition to roll out seven-day GP access to the whole of England by 2020. However, GP leaders have called it a political ‘pipedream’ as Pulse revealed CCGs in some areas of the country are rethinking their extended access plans due to lack of demand and cost-effectiveness.

This article was updated at 14:30 on 10 June 2015.