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Can seven-day GP access be delivered?

As GP practices struggle to recruit staff and out-of-hours providers struggle to fill shifts, many GPs claim that there simply is not the workforce to open evenings and weekends. 

A 184-hour week is a difficult ask when half of GPs are at high risk of burnout and the Government is falling far short of the 5,000 new GPs it has promised by 2020. Waiting times for in-hours appointments are up 30% in a year and the rate of GP practice closures is accelerating. GP leaders argue that seven-day access is a luxury that the NHS cannot afford.

But the Government is adamant that it will deliver on its flagship manifesto pledge. Since the policy was announced in 2013, millions and millions of pounds has been plunged into the scheme to ensure it continues. Mr Hunt recently told Pulse that access to 8 ’til 8, seven-day GP should be delivered as they had been ‘a clear manifesto commitment’.

The scheme may reduce A&E attendances, but it is clear that demand is not uniform over the weekend. GPs tell Pulse that Saturday afternoons and Sunday clinics are often nearly empty, and this is backed up by the official evaluation of the first year by NHS England.

The cost of extended hours GP access was between £30 and £50 per appointment offered, comparatively high when compared with the £136 per patient annually that practices receive for unlimited access in core hours.

CCGs have baulked at the cost of providing increased access to GPs at evenings and weekends. A Pulse investigation last year found that only two of the 19 first-wave areas providing seven-day access had fully committed continued funding. Even enthusiastic areas, such as Bury – which has been held up by the Department of Health as evidence of the scheme’s success – were unclear about whether they will pursue the scheme. 

But NHS England has been propping up the schemes with briding funding. And in some areas, GPs are positive about the additional funding and infrastructure the bids have brought.

Seven-day access will form part of a new voluntary GP contract to be published by the Government later this year, although this is likely to be on top of GMS/PMS and be providing this across populations of at least 30,000 patients. 

But the biggest question mark comes as the biggest champion of the scheme – Prime Minister David Cameron – has now resigned.

However, Mr Cameron’s successor, Theresa May, seems intent on honouring her old boss’ seven-day GP access ambitions. Health secretary Jeremy Hunt recently reaffirmed NHS England’s mandate to ensure evening and weekend access to GP appointments.

In a written ministerial statement in July, Mr Hunt said that he expected NHS England to ‘make further progress’ on the ‘priority’ of rolling out the seven-day NHS commitment including ‘to improve access to GP services, particularly in evenings and at the weekends’.

2016 seven day access click back banner 580x60px 2

2016 seven day access click back banner 580x60px 2