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23rd June 2016

Is 7 Day Access The Answer?

A Reduction in A&E Attendances

The topic hasn’t gone away but the stats keep coming, and Pulse Today has recently reported that “Seven-day GP working shows 'significant' reductions in A&E attendances”. It’s a sweeping statement and there is of course more detail within the report, with GP leaders calling for caution in interpreting the study, which contrasts with others which found Sunday’s weren’t as popular, but it claims ‘A&E attendances were reduced by 10% across the week among patients whose practice was piloting seven-day access, with reductions of 18% seen on Saturday and Sunday.’

Should We Be Open All Hours?

The Prime Minister, David Cameron, has said “Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life. We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week. We also want greater flexibility, so people can speak to their family doctor on the phone, send them an email or even speak to them on Skype.” Health Secretary, Jeremy Hunt, has also said “We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people. Cutting-edge GP practices in Manchester are leading the way, and we want many more patients across the country to benefit.”

Did Not Attends (DNAs)

But what about those patients who don’t feel it’s that important to attend their booked appointment, even when it should be more convenient for most at weekends? NHS England continually urges the public attend their appointments and, when the average DNA rate per month stands at 1.88% of the list size, i.e. 188 DNAs per month for a 10,000 patient practice, it does seem frustrating that we are being encouraged to offer appointments at weekends when they aren’t necessarily as popular, and some patients are more likely not to attend. We already know that DNAs can cause delays in treatment for other patients, and simple initiatives such as sending email and text reminders, which are now used by many surgeries, can have a positive impact.

Demand Needs Capacity

No one would dispute the fact that people need to be able to see their GP at a time that suits them and their family, but this needs to be reasonable and practicable. However, without an increase in the number of GPs, practice nurses, receptionists, secretaries and other ancillary workers, plus seven-day access to laboratory and x-ray facilities, most feel it is unachievable. This debate will rumble on and on, and I really don’t know when or if it will end.



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Alison Lowerson

GP Specialist

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