Scots face ‘postcode lottery’ over GP appointments

PATIENTS in Scotland face a postcode lottery when it comes to making an appointment with their family doctors, new research into access to general practitioners has claimed.
The way in which GP practices allow appointments to be booked varies widely. Picture: GettyThe way in which GP practices allow appointments to be booked varies widely. Picture: Getty
The way in which GP practices allow appointments to be booked varies widely. Picture: Getty

A survey of all 996 GP ­practices in Scotland has uncovered a wide variation in the availability and the method of making appointments with doctors.

The research by the political think-tank Reform Scotland found some GP practices allow patients to book appointments up to six weeks in advance, while others only allow appointments to be booked for that day.

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Only 39 per cent advertise extended hours on their websites, and even then there can be a huge variation in what is offered, with some offering only an extra hour a week.

The report, titled Examining Access: Survey Of GP Practices In Scotland, found that only 67 per cent of surgeries have their own website.

It says only 51 per cent of surgeries allowed patients to order repeat prescriptions online, and just 10 per cent had online booking facilities for appointments.

Alison Payne, Reform Scotland’s research director, said: “At this time of year it is especially important that people are aware of when their GP practice is open, and what procedures they should follow should they need a GP when the surgery is closed. Therefore it is astonishing that in 2014 only 67 per cent of surgeries have a website. This also highlights that issues around GP access are not just for Christmas.

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“Our research also indicated that throughout the year there can be wide variations in when different surgeries are open. Some allow patients to book appointments up to six weeks in advance while others only offer on-the-day appointments, and some offer extensive extended hours while others offer none at all.

“In 2010 the Royal College of General Practitioners, in partnership with the Scottish Government, developed a toolkit highlighting the benefits of allowing patients to order repeat prescriptions and to book appointments online. Yet four years later only 51 per cent and 10 per cent of practices respectively offer these services.

“It is simply unacceptable there is such a wide variation in the way people can access GP services across Scotland, a variation that has nothing to do with the size or geography of the area covered by different practices.”

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Payne added: “Giving individuals greater choice over their GP practice would mean that people were able to easily walk away from GP practices they felt did not provide services that suited them.

“We don’t envisage that such a policy would lead to a mass exodus of patients, but the potential that they could would help ensure that services developed to meet their needs.”

Dr Alan McDevitt, chair of BMA Scotland’s GP committee, took issue with the report’s findings.

“Once again Reform Scotland has shown a lack of understanding of the reality of the work and structure of general practice. What some call a postcode lottery others would call local flexibility with a proportion of services agreed locally between the health board and individual practices according to local priorities,” McDevitt said.

Patients across Scotland can choose from a number of GPs, with some obvious exceptions, such as in rural ­areas. GP practices are fundamentally there to serve the needs of their local population.”

A Scottish Government spokeswoman said: “The number of GPs in Scotland has increased by 6.9 per cent under this government. There are more GPs per head of population in Scotland than in England, and we also spend more on GP services per head of population.

“We expect boards to work with local medical committees and other partners to ensure they are delivering safe, effective, sustainable GP services that meet the needs of local communities.

“We regularly engage with the profession on improving patient access, and since 2008 an enhanced service arrangement has been in place to extend GP surgery opening hours beyond core hours.

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“We understand that there is no ‘one size fits all’ solution, which is why each practice has to take steps to understand its own demand and pressures and develop a package of actions to tackle them.

“It is encouraging the most recent Health and Care Experience Survey showed 92.4 per cent of patients were able to see a GP within 48 hours.

“However, we recognise more can always be done, and additional funding of £40 million in GP and primary care services over the next year was announced in November.

“This will be used to support new ways of delivering local GP and primary care services that can better support the changing demographics of the Scottish population.”

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