NHS reforms

GPs reject May’s call for ‘misguided’ seven-day care

GPs have rejected the prime minister Theresa May’s demand for GPs to open seven days a week, arguing that they are already struggling to cope with existing patient demand.

Last week May intimated that the limitation currently existing on general practice was putting A&E departments under increased pressure this winter and proposed a scheme in which GPs would offer routine services from 8am to 8pm every day.

But the Royal College of GPs (RCGP) has called the scheme “misguided”, saying that there is not historically been great patient demand for extended opening hours and instead suggesting greater integration between GPs and out-of-hours services.

Professor Helen Stokes-Lampard, chair of the RCGP, said: “It’s extremely unfortunate that the prime minister is being reported as pushing forward with a misguided scheme to force GP surgeries to offer routine services 8-8, seven days a week, regardless of patient demand or local resources.

“It is not the case that GP surgery routine opening hours are contributing to the pressures our colleagues in A&E departments are currently facing. GPs and our teams are also struggling to cope with increasing patient demand without enough investment, and without nearly enough family doctors and practice staff to deal with it – this is a year-long problem for us, not just during the winter.”

The RCGP said that practices have had to stop offering extended opening hours “in many cases” due to a lack of patient demand, but the government has asked practices to prove this claim or force them to make the change under threat of withdrawing funding.

Stokes-Lampard added that practices are often closed for good reasons and are still offering care, such as staff training or for GPs to conduct telephone consultations or home visits.

“A patient will always be able to access urgent GP care when they need to, either through our routine service, or the GP out of hours service,” Stokes-Lampard continued. “What we need is more integration between the two, and more information for patients so that they know where to turn for appropriate care when they are sick.”

Dr Chaand Nagpaul, GP committee chairman for the BMA, argued that much of the pressure on A&E services “has nothing to do” with general practice, but actually with a growing number of seriously ill patients whose admission to hospital a GP would not be able to prevent.

“This is not the time to deflect blame or scapegoat overstretched GP services, when the fundamental cause of this crisis is that funding is not keeping up with demand,” Dr Nagpaul stressed.

“The government should take responsibility for a crisis of its own making and outline an emergency plan to get to grips with the underlying cause, which is the chronic under-resourcing of the NHS and social care.”

General practice currently sees over 1.3 million patients across the UK every day, making up for 90% of all NHS patient contacts, according to the RCGP. However, it only receives around 8% of the NHS budget, leading GPs to argue that they provide the most “cost-effective” care in the NHS.

The RCGP has called upon the government to honour NHS England’s GP Forward View which has promised an extra £2.4bn a year for general practice and five thousand more GPs by 2020.

Last year the National Audit Office found “no evidence” that seven-day opening of GP practices would prove cost-effective for the NHS or the Department of Health. Meanwhile, the NHS Confederation has said that the decision on whether to implement the change should be made by local areas.

(Image c. Anthony Devlin)

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