Longer GP opening hours would require £2bn shift of funding into primary care, says GP leader

The government’s plans for patients in England to have access to a general practitioner any day of the week and in the evenings would require an investment of £35 (€41; $56) per head of population, a senior GP has claimed.

Ministers last week set out plans to trial a new scheme that would make it possible for patients to see their GP from 8 am to 8 pm, seven days a week, funded by £50m to be shared among nine pilot sites covering half a million people.1

James Kingsland, a Department of Health adviser on commissioning and president of the National Association of Primary Care, said that extending GP opening hours across England could be cost neutral—but would require the government to redistribute up to £2bn of funding from elsewhere in the NHS to primary care.

Speaking at the Commissioning in Healthcare conference in London on 8 October, Kingsland said that evidence from his own practice on Merseyside, which has trialled extended opening hours between 8 am and 8 pm Monday to Friday, indicated that additional investment could generate savings by reducing hospital admissions, preventing readmissions, or facilitating earlier discharge.

He said that his practice had received sufficient funding to allow it to become what he termed a “never-full” practice, which in turn had a “quite dramatic” impact on urgent care activity.

“If a patient [in my practice] says, ‘I need to be seen today’ they are seen. If they want to book a month in advance, they can,” he said. “If the registered list is serviced by a practice that is never full and has the right resources, the effects on urgent care are quite dramatic.”

He added, “My evidence is that to have a never-full practice, where patients register, get all the services they need within the 8-8, you need to increase—on top of the GP contract—£15 per head of population. To extend that to weekends, you need to add £20 per head. So our evidence is that £35 per registered head of population could deliver a service that is 8-8 seven days a week for most practices.”

Kingsland said that rolling out extended hours across the whole country would require the will to move funding from elsewhere in the system to general practice. He added that resources could be freed up by contracting differently for emergency care to account for reductions in activity, as well as reviewing the provision of walk-in centres and NHS 111.

He said, “The evidence is there. I think we can release the resource from the current system at a level which invests about 2% more of the NHS budget in the primary care system of general practice. If that is made available to general practice, we’ll have more than the nine sites putting their hands up.”