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- The Reformer Blog
26 October 2015
The Government’s ambition to create the “first nation in the world to provide a truly 7 day NHS” has set the agenda for health-service reform in the new Parliament. The vision has, however, been attacked by parts of the medical profession. Junior doctors are up in arms over new contract proposals. There has also been agitation at the pledge to ensure seven-day access to general practices in England: Maureen Baker at the Royal College of General Practitioners suggested seven-day services risk the “destruction” of general practice.
Any sober analysis should consider the people the NHS exists to serve: the public. While overall satisfaction with general practice is high (85 per cent in the latest GP Patient Survey), satisfaction with GP opening hours is falling, as the below chart shows.
Ivan Benett, clinical director at the NHS Central Manchester Clinical Commissioning Group, has pointed out that while these figures are “pretty high”, it is worrying that one quarter of people are not content with GP opening hours.
More worrying are the figures under the surface of these headline numbers. The GP Patient Survey also shows that only 60 per cent of people in full-time work believe current opening times are convenient; 67 per cent of full-time workers are satisfied with GP opening hours.
Seen through this lens, the need to improve access to general practice, particularly for those in full-time work, becomes pressing. The Government is therefore right to commit to rolling out seven-day access to general practice across England by 2020.
The real question, then, becomes: how? The Government has announced a “new deal” for general practice, which pledges to increase the number of GPs by 5,000 by 2020—however, questions have been raised over the achievability of this. It also stated that primary care would get a larger share of the overall NHS budget—but it is not clear how much. Furthermore, the prime minister has explained that there will be no extra money to fund seven-day services beyond those already announced. Some are not convinced that this is enough to achieve seven-day services.
Reform has recently argued that innovation to make better use of current resources will be key to achieving primary-care reform. An NHS Alliance report recently highlighted that 27 per cent of GP appointments could be avoided through more coordinated working between GPs and hospitals, as well as the wider use of other primary care staff and better use of technology. Closely involving pharmacists in the provision of primary care has also been seen as a means to “improve patient safety and care and, crucially, reduce waiting times for GP appointments.” It is this innovation that might unlock the door of seven-day services that the public desire.
Alexander Hitchcock, Researcher, Reform