A National Audit Office report on Improving patient access to general practice was published in January 2017. It says: 'We have not seen evidence that the Department and NHS England fully understand the effect of this commitment to extend hours on continuity of care or other arrangements for providing general medical services outside of core hours.'
The headline to the BMA website’s comment on the NAO report: Patient access to GPs in 'complete disarray’ makes that organisation's views clear.
In their article Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey (BMJ Quality and Safety Online; June 2016), Cowling, Harris and Majeed say their findings (question) 'expected impacts of current plans to extend opening hours on patient experience'. In a Guardian article from October 2016, Zara Aziz argues that Seven-day working for GPs costs more and doesn’t get results.
In October 2015, the Prime Minister’s Challenge Fund published its first evaluation: Improving Access to General Practice: First Evaluation Report (October 2015.) It found that 'at May 2015, there had been a 15% reduction in minor self- presenting A&E attendances across the pilot schemes (with extended opening hours) compared with the same period in the previous year'. The issue of reduced presentation at A&E is explored in the BMJ article: Improving access to GPs will help reduce pressure on emergency departments, says NHS (BMJ 2013; 347; published 23 December 2013) and also in the PLOS article Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis (September 2016) which concludes that 'extending access was associated with a reduction in emergency department visits'.
Research at the University of York Centre for Reviews and Dissemination found less impact on A&E. The evalution report Enhancing access in primary care settings published in June 2015 also found that extended week-days and Saturdays were more appealling the Sundays and that 'telephone consultation shifts the workload from face-to-face to telephone contact and increases the number of primary care contacts within 28 days of the initial consultation'.
As well as extended opening hours, telephone access, GPs can also improve access by offering additional services and using information technology more imaginatively. The Care Quality Commission GP case studies Improving access to care cover the use of extra services to improve access to care and using video-chat technology.
