Despite failed pilots, huge hostility from those who would have to deliver the service and reticence from the general public, Jeremy Hunt seems to be on a mission to deliver 7 day access to primary care sooner rather than later. So, in order to address the concerns of practice managers and actually be able to deliver an effective 7-day solution, what needs to change?
- More funding
It might be obvious to all but NHS England, but this scheme has to be funded somehow. It’s not just GPs that need to be paid for, either – it’s admin staff, practice managers, pharmacists, nurses… the list goes on. Without an injection of funding, the scheme will surely fall at the first hurdle and simply drive more people out of the profession.
- More GP recruitment and training
Another reason for the scheme falling at the first hurdle is a lack of GPs. Without more to cover the increased hours, how can already overstretched GPs be expected to do more? How you recruit and where from is a big debate, but it’s one that needs resolving in order for 7-day opening to succeed.
- Effective marketing
Pilot schemes trialling 7-day opening have not been very successful. However, one of the reasons for this lack of success cited is the lack of marketing by all involved, from CCGs down to GP practices. One practice manager told us: “Short-term pilots don’t necessarily provide the best indication of public demand, especially if they haven’t been made aware of the new opening hours. For it to be successful I think it needs to be a full nationwide roll-out backed up by intensive national advertising campaigns. That of course costs money and given this government’s record it’s therefore unlikely to happen.”
- Take a flexible approach
If funding is made available and a sudden tranche of new GPs is uncovered, many still think 7-day opening is not the answer. Instead, many practice managers suggest a flexible approach to opening is a better way to go, with early mornings and late nights supplementing ‘traditional’ opening hours. What works in an urban practice in central London might not work in a rural practice in Northumberland!
- Provide better access to practice support
On the Practice Index Forum, many practice managers are suggesting that, for 7-day opening to be successful, 7-day access to routine laboratory tests, MRI/X-Rays and so-on needs to be guaranteed.
“It’s no point me being open and paying for a GP/dispenser/receptionist AND heating/lighting etc., for routine appointments if we can’t do anything useful for the patient, other than suggest they come back Monday to Friday between 9am and 1pm!”
Another practice manager added: “Who do we call at 19:55 on a Sunday night when our computers stop working? Who’ll collect those blood samples to go to the labs?”
- Seven day pharmacy support
If GP practices are to treat patients 7 days a week, pharmacies need to be dispensing the required medicines every day too – the two go hand-in-hand.
- Start asking those at the coalface
Finally, if 7-day opening is to work, perhaps NHS England should start asking people who actually work in primary care for their views (and take them on board). That way we might find some realistic answers to the problems that need to be addressed.
The way forward
Plenty needs to change in primary care if 7-day opening is to succeed. Alternative ideas such as bolstering the Out Of Hours service already in place, providing primary care hubs that cover 100,000 patients or more, and forcing employers to give their staff time off to visit their GP seem far more workable. In the meantime, prepare yourselves for far more posturing by politicians on this subject.
What are your views on 7-day opening? Please let us know by commenting below or in the forum here.