GPs hit back in row over extending hours

The Prime Minister has expressed frustration at the failure of more GP practices to offer extended opening hours, amid intensifying pressure on NHS hospital services.

Downing Street warned surgeries in England which refuse to move to 8am to 8pm opening, seven days-a-week will lose funding unless they can prove there is no demand from patients.

The British Medical Association hit back angrily, accusing ministers of trying to “scapegoat” doctors rather than address the chronic underfunding which was the true cause of the crisis in the NHS.

Dr Chaand Nagpaul, the BMA GP committee chairman, said they were facing a “major alert” with one in three GP practices reporting unfilled vacancies while eight in 10 said they were unable to provide safe care.

“We have got a very serious problem that we don’t have the capacity in general practice. The crisis in the NHS won’t be solved by scapegoating or deflecting blame on to GPs,” he said.

“All patients can see a GP 24 hours a day, 365 days a year. Patients can see a GP when they need to. What we cannot be providing is stretching a service where we are struggling - and we do manage in spite of the pressures - into a seven-day service.”

Professor Helen Stokes-Lampard, the chairwoman of the Royal College of GPs, said the Prime Minister’s intervention was “extremely unfortunate” and the plans were “misguided”.

“It is not the case that GP surgery routine opening hours are contributing to the pressures our colleagues in A&E departments are currently facing,” she said.

“GPs and our teams are also struggling to cope with increasing patient demand without enough investment, and without nearly enough family doctors and practice staff to deal with it - this is a year-long problem for us, not just during the winter.

“It has never made sense to force GPs to offer services that there is little patient demand for. In many cases practices have already had to actually stop offering extended opening hours because of a lack of patient demand for them.”

The row comes amid increasing exasperation among ministers that the unavailability of GP appointments is driving patients to seek treatment in hard-pressed hospital accident and emergency departments.

The director of acute care for NHS England, Professor Keith Willett, has recently estimated that 30 per cent of the patients attending A&E would be better cared for elsewhere in the system.

Meanwhile the latest official figures showed more than four in 10 hospitals in England declared a major alert in the first week of the year as services came under increasing pressure.

A Downing Street source said: “Most GPs do a fantastic job, and have their patients’ interests firmly at heart.

“However, it is increasingly clear that a large number of surgeries are not providing access that patients need - and that patients are suffering as a result because they are then forced to go to A&E to seek care.

“It’s also bad for hospitals, who then face additional pressure on their services.”

Ministers say they are providing an additional £528 million a year for practices by 2020/21 to ensure that the target for providing seven-day opening is met by that date.

However they are concerned by a recent finding by the National Audit Office that 46 per cent of GP surgeries were still closing at some point during “core” weekday working hours - with 18 per cent closing before 3pm a least one day a week - despite three-quarters of them having received extra funding to provide extended cover.

They also suggest some surgeries are failing to advertise the availability of extended hours appointments and GPs will be warned future additional cash will be contingent on them demonstrating they are offering appointments when patients want them.

Ministers are now considering asking surgeries to use a new online appointments tool to submit data on the numbers and types of appointments they offer so they can better understand patient demand.