Labour figures show fall in number of GP surgeries offering extended hours

Labour’s shadow health secretary, Andy Burnham, has come under fire after blaming the coalition government’s policies for a fall in the number of general practices in England that offer extended opening hours.

Laurence Buckman, who chairs the BMA General Practitioners Committee, accused Burnham of “hiding behind a fig leaf,” saying that the policy of extending weekend and evening hours, which the previous Labour government had “imposed” on the profession, had never worked.

He told the BMJ, “People who were seen in extended hours weren’t the ones it was intended for.”

The Labour party released a survey of GPs’ opening hours in England, published on 26 July, using figures from 91 of England’s 151 primary care trusts.

It found that 56% of the primary care trusts reported a decrease in the number of surgeries offering extended opening hours during evenings and weekends in 2011-12.

Among the 91 trusts, 234 fewer general practices offered extended opening hours in 2011-12 than in 2010-11, a fall of 5.7% (from 4087 to 3853).

Labour said that only 11 primary care trusts reported an increase in the number of surgeries seeing patients during evenings and weekends, while some 12 NHS walk-in centres had closed, pushing hospital emergency departments to “breaking point” under the increased pressure.

The party carried out the survey after the Department of Health ceased collecting data nationally under changes to the extended hours access scheme that took effect from 1 April 2011.

Burnham said that many more patients were now unable to see their GP at a convenient time, despite a pre-election commitment by the prime minister, David Cameron, to enable appointments up to 8 pm, and that this was harming care.

He said that primary care trusts and GPs were most likely distracted by NHS organisational upheaval and potential concerns over conflicts of interest and may have seen the end to national monitoring as a signal that extended opening hours were no longer a priority.

He said, “The prime minister needs to get a grip on the NHS and focus on restoring order in our A&Es [accident and emergency departments], bring back longer surgery opening hours, and halt the closure of walk-in centres, pending an urgent review.”

A health department spokesman said that the requirement to offer extended opening hours had always been “optional.”

In 2008 the previous Labour government gave general practices the option to extend opening hours by 30 minutes a week for every 1000 registered patients. This had to be in blocks of at least 1.5 hours after 6 30 pm and on Saturday mornings, although shorter blocks were allowed for appointments before 8 am and for practices with fewer than 3000 patients. For the average surgery this meant, in order to retain funding, opening an additional three hours a week.1 2

The health department spokesperson said, “This government introduced a greater level of flexibility to the system, meaning extended sessions could be divided over any number of working days instead of in 30 minute blocks. It also allowed other healthcare professionals, such as nurses, to run them.

“Patients have the freedom to choose which GP practice best meets their needs. However, an independent MORI survey found that only 7% of patients questioned were unhappy with the opening hours available.”

Buckman said that although the system had become “slightly more flexible” since the coalition government’s changes were introduced, this hadn’t improved access, and he suggested that the government should “get rid of it.”

Charles Alessi, who chairs the National Association of Primary Care, said that an overarching strategy was needed to deal with urgent care, including extended hours, out of hours services, walk-in centres, and accident and emergency services.

“We haven’t managed the service comprehensively, and that is a fundamental problem,” he told the BMJ.