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Influential MPs question rollout of seven-day routine GP appointments



The Government needs to make a full evaluation of seven-day GP access pilots before any new system is rolled out, the House of Commons Health Committee’s primary care inquiry has concluded.

The committee, headed by Tory MP and former GP Dr Sarah Wollaston, said the Government needed to collect more evidence on the policy, noting that evaluation of the scheme in 2015 found high take-up of extended-hours appointments in the week and on Saturday mornings, but very low take-up on Sundays.

The Health Committee’s report, which refers to Pulse’s investigation into the seven-day pilots, recommended that the Government’s approach to the policy should be ‘evidence based’ and avoid unintended consequences such as damaging weekday services, continuity of care or existing urgent out-of-hours primary care services.

But it comes as NHS England last week pledged £500m a year to CCGs to commission seven-day routine GP access across England.

The MPs’ report said: ‘The Government should bear in mind evidence that there may be more demand for access to GPs in the evenings or on Saturdays than on Sundays.’

But the report welcomed ‘the principle’ of improving access for people ’whose working lives make it very difficult to obtain appointments during the week’.

The report called for CCGs to be given ’the flexibility to develop local solutions for weekend access to meet the needs of those who cannot attend routine services between Monday and Friday’, while taking ’account of the impact on local provision of existing out of hours services for urgent primary care’.

It also said that the implementation of the Government’s seven-day manifesto pledge must come with adequate funding and resource.

On the wider challenges facing general practice, the committees recommendations included advising the Government to:

  • Publish an analysis of doctors leaving the profession.
  • Put more emphasis on medical schools teaching and promoting general practice as a career, with schools with an inadequate number of graduates going into the profession held to account by the GMC.
  • Give a larger proportion of overall NHS spending to general practice in order to improve access and services for patients. It quoted Pulse’s submission to the inquiry, which it said ’highlighted the relationship between funding changes and practice closures’.

Policy set for full rollout

Despite warnings, last week’s General Practice Forward View pledged £500m a year to CCGs to commission seven-day routine GP access across England.

In a slight rollback on the Government’s manifesto pledge of routine seven-day access for all, the Forward View did add that this would be based on ‘locally determined demand’.

Pulse has reported that almost half of the Challenge Fund/GP Access pilots have already reduced opening hours, amid lacking patient demand and uncertainty over future funding.

And the official interim evaluation recommended Sunday opening is ditched due to a lack of demand, with the potential of commissioning extended evening opening or Saturday morning clinics.

As revealed by Pulse, NHS England is providing ongoing funding to all of the Prime Minister’s seven-day access pilots after their funding has run out, despite plans for them to become self-sustaining by cutting the number of A&E attendances at weekends and evenings.