As a PM, what do you most like to do on a Saturday?
A) have a long, well-deserved lie-in
B) go for a refreshing walk in the hills with your dog/family
C) catch up on a week’s worth of TV/cleaning/reading/hobbies/fun
Well, you might be kissing goodbye to those leisurely Saturdays soon.
The future could see all GP surgeries opening on Saturdays, and offering a seven day service for patients.
In London, as part of a £810m shake-up of service, practices are expected to merge or establish a federation of local practices in order to provide 7-day care, as well as provide a range of new services, including a telephone triage service and flexible appointment times, from as soon as April 2015. These new initiatives represent the biggest change in GP practice in recent years.
So, what will the benefits be?
– Pressure on A&E reduced: we’ve all seen the evidence that people are regularly visiting A&E with minor conditions, particularly on weekends, because they can’t get an immediate appointment with their GP. Increasing the opportunities patients have to access their local health care professionals could see the pressure on casualty departments reduced whilst providing people with a more accessible service.
– Improved patient care: working people are often not able to get to their GP during the current hours they are open. Patients don’t choose when they get ill and having a wider provision across the week makes sense. Even the Royal College of General Practitioners agree that we need to move towards a provision that is tailored more to local needs.
And the pitfalls?
– Providing 7-day GP cover: Most provide cover for emergencies over the weekend, but there are only two ways that a small GP could provide a comprehensive service over seven days. One would be to reduce their hours during the week, the other would be to bring more GPs into the system.
– Lack of continuity: Adjusting the hours a GP is available could also have significant effects on continuity of care. Vulnerable groups such as the elderly, those with long term health problems and expectant mothers, prefer to see a familiar doctor who knows their history.
So is it going to work?
Despite the obstacles, a number of GP surgeries are already beginning to offer Saturday openings. In Stoke and North Staffordshire they are opening for urgent appointments as a trial run until Valentine’s Day next year.
Whether there are resources to extend Saturday openings to a 7-day a week provision is currently debatable, but the pilot in London which will see practices ‘federating’ into Multispeciality Community Providers, may hold the key.
Providing more resources to local GPs will inevitably involve a shift in finance, the current London pilot costing some £810 million a year. And that may well be the ultimate defining obstacle.