Skip to main content

Opening hours of general practices in England

A letter published in the BMJ discusses the question: should general practices open for longer?’  The recent proposal for GPs in England to see patients from 8 am to 8 pm, seven days a week [2] tells us little about how much longer the hours in which GPs provide consultations would become. We therefore analysed data, obtained from NHS Choices [3] on 1st October 2013, on the ‘surgery’ (as opposed to ‘reception’) opening hours for 8,973 general practices in England.

Surgery opening hours currently total 341,857 hours per week; the median value is 40 hours per week. The median for opening hours outside of core hours (8 am to 6.30 pm, Monday to Friday) is 1.25 per week.

If the Government’s proposal was implemented nationally in each general practice, surgery opening hours would total 753,732 hours per week (a 120% increase). Each practice would provide consultations during 84 opening hours (a 110% increase over the current median), and 31.5 hours outside of core times (as defined above; a 2,420% increase), per week. Only 70 practices (0.8%) are open for 84 or more surgery hours per week currently; 83% of practices are not open at all at the weekend.

The results help to estimate the scale of the proposed intervention if implemented nationally and suggest significant financial and staffing implications. However, surgery opening hours may be a less informative measure than the number of hours of consultation provided per week (as, for example, two GPs could provide two hours of consultation within one opening hour). Does the Government intend to increase the number of consultation hours per week, in addition to extending surgery opening hours?

In the GP Patient Survey 2012-13, [4] 89% of respondents (Q12; n=907,732) indicated being able to get an appointment to see or speak to a GP or nurse on their last attempt, and 92% of this group reported the appointment as convenient. Additional consultation hours could help to meet the remaining, unmet demand; though this will not necessarily reduce the occurrence of A&E attendances, and the possibility of supply induced demand is also present.

Comments

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

New NHS community mental health centres in England

The Government has announced it will create over 100 new community mental health centres across England, which will work alongside GPs and other NHS organisations/ The centres will offer offer walk-in support as well as seeing patients referred from elsewhere in the NHS. GPs have long called for faster access to specialist mental health support for patients, so the expansion of community mental health services is a welcome development. If these new centres improve access to multidisciplinary teams, reduce waiting times and provide more integrated care, they can improve patient outcomes while reducing pressure on both general practice and specialist mental health services. Close collaboration between GPs, mental health professionals, social care and the voluntary sector will be essential because many people with mental health problems also have wider social and physical health needs. The success of these centres will depend on how they are implemented. They need to be adequately staffe...

Protecting Young People from Meningococcal B Disease: The NHS Targeted Vaccination Programme

Meningococcal group B (MenB) infections are rare but can have devastating consequences. The decision to offer a targeted two-dose vaccination programme to Year 13 students and young people entering university or residential further education reflects concerns about recent outbreaks of meningococcal disease and the higher risk of transmission when large numbers of young adults mix closely for the first time in shared accommodation. The MenB vaccine has a well-established safety record, and evidence from the UK infant immunisation programme has shown substantial reductions in disease among vaccinated children. A targeted programme for those entering higher-risk settings is therefore a reasonable precautionary measure while further evidence is gathered on whether the recent increase in clusters represents a temporary fluctuation in disease patterns or a more sustained change in the epidemiology of MenB infection. The success of the programme will depend on achieving high uptake and ensuri...