BMJ 2013;347:f7570 doi: 10.1136/bmj.f7570 (Published 23 December 2013)
Page 1 of 1
Letters
LETTERS GENERAL PRACTICE OPENING HOURS
Opening hours of general practices in England Thomas E Cowling National Institute for Health Research doctoral research fellow, Matthew J Harris academic clinical lecturer in public health, Michael A Soljak clinical research fellow, Azeem Majeed professor of primary care Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
The head to head debate on general practice opening hours does not specify the number of additional opening hours.1 Similarly, the proposal for GPs in England to see patients from 8 am to 8 pm, seven days a week, tells us little about how much longer GPs would provide consultations.2 We analysed NHS Choices data, obtained on 1 October 2013, on surgery (rather than reception) opening hours for 8973 general practices in England (www.nhs.uk/).
In these practices, surgery opening hours total 341 857 h/week (median 40 h/week. The median outside of core times (8 am to 6.30 pm, Monday to Friday) is 1.25 h/week.
If the government’s proposal was implemented nationally in each general practice, surgery opening hours would total 753 732 h/week (120% increase). Each practice would provide consultations during 84 h/week (110% increase) and 31.5 h/week outside of current core times (2420% increase). Currently, only 70 practices (0.8%) are open for at least 84 surgery hours a week; 83% of practices provide no consultations at the weekend. These results indicate the scale of the proposed intervention and the considerable financial and staffing implications. In addition, does the government intend to increase the number of consultation hours each week, as well as extending surgery opening hours (for example, two GPs could provide two hours of consultation in one or two surgery opening hours)?
In the GP Patient Survey 2012-13,3 89% of respondents (n=907 732) indicated being able to get an appointment to see or speak to a GP or nurse on their last attempt. Additional consultation hours could help to meet the remaining unmet demand, although this might not reduce emergency department attendances, and supply induced demand is possible. Competing interests: None declared. This letter is independent research supported by the National Institute for Health Research (NIHR; doctoral research fellowship, Thomas Cowling, DRF-2013-06-142). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Full response at: www.bmj.com/content/347/bmj.f6832/rr/675084. 1 2
3
Kingsland JP, Swinyard PW. Should general practices open for longer? BMJ 2013;347:f6832. (19 November.) UK Government. Seven day, 8 am-8 pm, GP access for hard working people. 2013. www. gov.uk/government/news/seven-day-8am-8pm-gp-access-for-hard-working-people?utm_ source=rss&utm_medium=rss&utm_campaign=press-release-seven-day-8am-8pm-gpaccess-for-hard-working-people. Ipsos MORI. Technical annex for the GP patient survey: 2012-13 annual report. 2013. www.gp-patient.co.uk/results/download/_y7q2/Y7W2%20Technical%20Annex.pdf.
Cite this as: BMJ 2013;347:f7570 © BMJ Publishing Group Ltd 2013
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS GENERAL PRACTICE OPENING HOURS
Opening hours of general practices in England Thomas E Cowling National Institute for Health Research doctoral research fellow, Matthew J Harris academic clinical lecturer in public health, Michael A Soljak clinical research fellow, Azeem Majeed professor of primary care Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
The head to head debate on general practice opening hours does not specify the number of additional opening hours.1 Similarly, the proposal for GPs in England to see patients from 8 am to 8 pm, seven days a week, tells us little about how much longer GPs would provide consultations.2 We analysed NHS Choices data, obtained on 1 October 2013, on surgery (rather than reception) opening hours for 8973 general practices in England (www.nhs.uk/).
In these practices, surgery opening hours total 341 857 h/week (median 40 h/week. The median outside of core times (8 am to 6.30 pm, Monday to Friday) is 1.25 h/week.
If the government’s proposal was implemented nationally in each general practice, surgery opening hours would total 753 732 h/week (120% increase). Each practice would provide consultations during 84 h/week (110% increase) and 31.5 h/week outside of current core times (2420% increase). Currently, only 70 practices (0.8%) are open for at least 84 surgery hours a week; 83% of practices provide no consultations at the weekend. These results indicate the scale of the proposed intervention and the considerable financial and staffing implications. In addition, does the government intend to increase the number of consultation hours each week, as well as extending surgery opening hours (for example, two GPs could provide two hours of consultation in one or two surgery opening hours)?
In the GP Patient Survey 2012-13,3 89% of respondents (n=907 732) indicated being able to get an appointment to see or speak to a GP or nurse on their last attempt. Additional consultation hours could help to meet the remaining unmet demand, although this might not reduce emergency department attendances, and supply induced demand is possible. Competing interests: None declared. This letter is independent research supported by the National Institute for Health Research (NIHR; doctoral research fellowship, Thomas Cowling, DRF-2013-06-142). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Full response at: www.bmj.com/content/347/bmj.f6832/rr/675084. 1 2
3
Kingsland JP, Swinyard PW. Should general practices open for longer? BMJ 2013;347:f6832. (19 November.) UK Government. Seven day, 8 am-8 pm, GP access for hard working people. 2013. www. gov.uk/government/news/seven-day-8am-8pm-gp-access-for-hard-working-people?utm_ source=rss&utm_medium=rss&utm_campaign=press-release-seven-day-8am-8pm-gpaccess-for-hard-working-people. Ipsos MORI. Technical annex for the GP patient survey: 2012-13 annual report. 2013. www.gp-patient.co.uk/results/download/_y7q2/Y7W2%20Technical%20Annex.pdf.
Cite this as: BMJ 2013;347:f7570 © BMJ Publishing Group Ltd 2013
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
