I was really disappointed to hear NHS England’s director of primary care attributed in the Daily Mail as saying that ‘by curbing half day closures we will be freeing up hundreds of thousands of appointments at a time when we know it can sometimes be tricky to see your GP’. GPs being open more hours doesn’t mean more appointments, and surely she knows that this will instead lead to yet more practices closing (already, 445 closed in between 2013 and 2017, with nearly 140 last year alone, affecting over 500,000 patients) and more GPs giving up (already, there are 1,180 fewer FTE since 2015).
The practices hit hardest by this will also tend to be the smaller ones, working in more highly deprived populations – often the most valued by patients for the continuity of care and better access (as judged by patients in the National GP Patient Survey) they provide.
The practices hit hardest by this will also tend to be the smaller ones in deprived populations
This is just another push towards the megalogenesis of general practice, until all are serving populations of 30-50,000+ and patients have no continuity of care and GPs are community medics working shifts and seeing people they’ve never seen before and will probably never see again.
Surely it’s false advertising to say that amid falling GP numbers, practices opening longer is giving more appointments. General practice is now funded to provide a three and three quarter day service, and practices’ opening hours don’t equate with their capacity, whether through doctors, nurses or admin staff, to offer the standard of service that many, perhaps most, practices would aspire towards.
Dr Alan Dow is honorary secretary of the Family Doctors Association and a GP in Glossop