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What is the evidence for seven-day GP access?

Ministers have used various sources of evidence to justify their plans for a ‘truly seven day NHS’.

Seven day working in hospitals has been introduced on the back of data apparently showing an increased mortality rate at weekends, although the interpretation of these data have been disputed. But for GP practices the evidence supporting the seven-day access drive has been less clear cut. 

NHS England claims that opening later and on weekends could take the pressure off struggling A&E departments. And there has been some evidence to support this. 

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. A recent study by the University of Sussex found that seven-day GP access does result in significant reductions in the number of A&E attendances and admissions, but might be most effective in ‘strategically located surgeries’. Seven-day GP opening did little to divert A&E attendances for minor injuries, but it was effective for older patients and more affluent patients.

There may be more demand in the evenings or on Saturdays than on Sundays

An official evaluation by NHS England last year found there had been a ‘significant reduction in minor A&E attendances’ by patients of practices involved in the 20 first wave ‘Challenge Fund’ pilots. But the report also said that the GP seven-day access pilots had ‘very low utilisation of Saturday afternoon and Sunday GP appointments’, concluding that resources would be better off used elsewhere.

And Pulse has learnt of a number of CCGs which have discontinued part or all of their seven-day access schemes due to low utilisation or a failure to reduce hospital pressures

A study from the University of East Anglia found that just one in 250 people would benefit from wider introduction of Sunday GP appointments. The researchers looked at 881,183 responses to the GP patient survey, and found that four in five patients felt that their practice had convenient opening times. 

The House of Commons Health Committee recently recommended that the Government should make a full evaluation of seven-day GP access pilots before any new system is rolled out. The committee, headed by Tory MP and former GP Dr Sarah Wollaston, said the Government needed to collect more evidence on the policy.

The report, which refers to a Pulse 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.

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.’

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2016 seven day access click back banner 580x60px 2