GPs reluctant to extend appointment hours

Published on Friday 30 May 2008 23:38

MOST GPs in Scotland are shunning calls for them to open their surgeries during evenings and weekends, despite a pledge by ministers to increase access, The Scotsman can reveal.

Just 16 per cent of GPs have said they will definitely offer the extended opening for patients, according to new figures.

But the Scottish Government said it was encouraged by the numbers of doctors who had shown an interest in taking part in the scheme. It follows a fall-out between ministers and GPs who felt the plans – backed by 9.5 million extra funding and 6.5 million diverted from money they already receive – had been imposed without negotiation.

Under the plans – and to qualify for the funding – GPs must work an extra 30 minutes a week outside normal hours for every 1,000 registered patients.

About 170 practices out of around 1,000 in Scotland have said they will offer extra appointments. A further 200 have expressed an interest without making a firm commitment.

The picture varied across the country, with some health boards more successful than others in getting GPs to sign up to extended hours.

For example, in NHS Lanarkshire, 31 practices out of 98 said they were willing to discuss the possibility of extended hours.

In NHS Grampian, 19 out of 84 practices were in discussions with the health board.

Out of 101 practices in NHS Highland, 27 had signed up to extended hours and 18 have shown a willingness but are still considering their options.

But in NHS Fife, just nine GP practices out of 57 have so far signed up to extended hours, and in NHS Lothian, only three of 130 practices are considering it.

In NHS Greater Glasgow and Clyde, 25 per cent of the 280 practices said they would open earlier or later into the evening. But there was no interest from GPs in opening on Saturdays.

Dr Dean Marshall, chairman of the British Medical Association's Scottish GPs committee, said: "We are not against extended hours, we just don't think it's the best use of the money.

"The low numbers signing up is a reaction to the way that the Scottish Government tried to force us into this."

Nicola Sturgeon, the health secretary, said: "The extended hours arrangements are something that the public and patient groups put high on their list of priorities. This is an attempt to provide better, more accessible primary care services."

BACKGROUND

THE Scottish Government has said it wants to extend GP opening times to help people who find it hard to see a doctor during normal hours.

But health boards also view it as an opportunity to ease pressure on their other services, such as A&E.

NHS Lothian is hoping it can encourage more GPs to open their doors on Saturday mornings, when they see a surge in patients in A&E.

It is thought that as many as one in ten patients turning up at A&E should have been dealt with in primary care. Edinburgh Royal Infirmary's A&E department has seen a massive surge in patients – this year up to 115,000 are expected through its doors.

Dr Alasdair Gray, clinical lead in emergency medicine at NHS Lothian, said part of the reason for rising numbers was trouble accessing primary care.

"We still have patients pitching up because they can't access primary care," he said.

"We have to work at improving the level of access."

Dr Gray said Saturday GP openings could help reduce the numbers in A&E.