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GP access a question of timing

The announcement this week that over seven million patients in England are to benefit from extended GP opening hours sounds impressive at first. But with over 56 million people registered with GPs in England one might argue that too few will notice a difference.

The announcement this week that over seven million patients in England are to benefit from extended GP opening hours sounds impressive at first. But with over 56 million people registered with GPs in England one might argue that too few will notice a difference.

Funds to the tune of £50m from the so-called Prime Minister’s Challenge Fund have been allocated to 20 pilots, many of which will offer 8am to 8pm opening hours, seven days a week.

For patients who do not happen to live in one of the pilot areas, it is to be presumed there will be little change and they should continue to try getting an appointment to see their GP in the usual fashion.

What will happen after the year of funding is up is another outstanding matter. And details of how any successes of the initiatives might be embedded or spread are sparse. NHS England hints on its website that it is “looking to establish a number of ‘associate networks’ to the challenge fund that link other innovative bids within regions and nationally, to share learning”. Whether this amounts to anything more than rhetoric remains to be seen. The commissioning board was unable to provide The Journal with specific details.

That three of the 20 pilots have pharmacy involvement is a good thing — but what of the other 17? Considering that effective skill-mixing has long been viewed as an answer to the growing crisis in access to healthcare, there are arguably missed opportunities here. More puzzling is the fact that the move does not, as far as The Journal can tell, appear to have an obvious link to the work of NHS England’s “urgent and emergency care review” delivery group.

A cynic might also question the timing: if enough people (say, seven million) were to benefit from the schemes, that would certainly form a solid election campaign message after the many unsettling years of NHS restructuring.

No small amount effort has gone into NHS England’s recently closed “Call to action”. And ambitious changes to the shape of pharmacy — and primary care — described in many contributions to the consultation (for example, Agenda) could go a long way toward improving people’s access to care.

This is an issue of priorities and timing. The focus, now, needs to be on delivering a reform of national primary care contracting that rewards collaboration between all health and care professionals. This Government should avoid making any more grand commitments until a more sustainable vision, and plan for action, has been agreed.

Citation: Electronicjuice DOI: 10.1211/PJ.2014.11137463

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