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Living in a 24 hour world
I heard this week that a politician has allegedly claimed that “NHS Staff simply do not work hard enough. It is completely unacceptable that staff get days off and nobody bothers to come to work at the weekend.” If that insulting remark proves to be genuine, the fact of the matter is it’s just not true. Many practices offer excellent patient care outside of core hours (8.00am to 6.30pm, Monday to Friday), including providing extended hours appointments and meeting unofficial waiting targets. However, an analysis by the BMJ on pledges to improve GP access has highlighted the lack of evidence to demonstrate that plans to increase GP access through extended hours or 48 hour access targets would be achievable or effective.
What does the CQC think?
From the results of recent inspections it appears that the CQC feels that GPs are providing good patient access and are able to demonstrate, in numerous ways, how they offer patient care in excess of what’s contractually required. At the beginning of an inspection the CQC will ask the GP practice to present its own view of its performance, particularly in relation to the five key questions and six population groups, and to include any examples of outstanding care and practice. This is the perfect opportunity for practices to demonstrate the services they may offer in the evenings and at weekends, regularly and, of course, seasonally, e.g. Saturday flu clinics.
Back to square one
We live in a world now where patient expectations are higher than ever and we are asked to deliver routine patient care 24/7. However the BMA’s analysis questions whether the aim of providing seven-day access or guaranteed GP appointments within 48 hours will reduce pressure on other services. We are back to square one, trying to explain to the powers that be that the ‘interpersonal’ elements of care, such as continuity with a preferred GP, are most strongly associated with patient satisfaction, and that patients will often sacrifice quicker access to any GP in order to see their preferred GP.
Support is available
The impact the further external pressure put on GP practices creates even more internal workload for managers to deal with, and can lead to stress at work. The QCS Management System provides advice to practices to support them in managing and evidencing the care they provide, how they meet patient expectations, and also how to manage stress at work.
Alison Lowerson – QCS Expert GP Practice Manager Contributor