Manchester expands seven day general practice to three million peopleBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h3192 (Published 10 June 2015) Cite this as: BMJ 2015;350:h3192
Greater Manchester will become the first area in England to roll out full, seven day general practice services by the end of 2015, after an evaluation of pilot schemes showed a 3% reduction in emergency department activity.
The move, which will offer more than three million people access to full primary care and diagnostic services seven days a week, marks the first phase of the government’s plan to devolve Greater Manchester’s entire £6bn (€8.2bn; $9.3bn) health and social care budget to a new regional authority.1
Announcing the plans on 10 June, officials said that the evaluation of several pilots covering 500 000 people had found reductions in hospital emergency department activity and costs and increases in patients’ satisfaction.
The roll-out will act as a precursor to the implementation of seven day services across England by 2020, a key pre-election pledge made by the prime minister, David Cameron.
The extension of the scheme in Greater Manchester has been agreed with local medical committees (the local representative bodies for GPs) and will be funded by a combination of £8m from the prime minister’s national challenge fund and a further £7m from regional authorities.
Not all general practices will have to participate in the scheme or be open seven days a week, as the scheme will operate primarily through hubs and federations of practices. It will differ from the existing out-of-hours care system by offering people the ability to book appointments and allowing patients’ records to be shared across a joined-up seven day system.
Howard Bernstein, joint chair of the Greater Manchester Health and Social Care Devolution Programme Board, said, “Seven day access has the potential to transform health outcomes for the region, and it’s also part of wider measures to help take the pressure off hospitals.”
Ian Williamson, chief officer for Greater Manchester Health and Social Care Devolution, said, “Devolution hasn’t created these new seven day systems of working—but it can help to propel those results quicker across Greater Manchester, through a cemented regional partnership, increased freedoms, and flexibilities to make local decisions—and less bureaucratic impediment.”
Tracey Vell, chair of the Association of Greater Manchester Local Medical Committees and chief executive of Manchester Local Medical Committee, said that the local committees were initially wary of the pressure the plans might place on general practices but added that they would support the plans after receiving reassurance on funding and arrangements.
“It’s commissioned and funded separately, which means individual practices are not overwhelmed, making workload pressures worse,” said Vell. “We’re happy to support it in this form and hope to continue to represent the views of the GP workforce as the plans fully develop this year.”
The scheme is part of Greater Manchester’s wider plan to become the first region in England to take direct control of health and social care budgets. The devolution of spending power has been backed by the Treasury and Chancellor George Osborne as part of the government’s Northern Powerhouse project. But it has drawn criticism from some doctors, who believe that devolution on this scale will hasten the break-up of the NHS. In a recent blog post for The BMJ the Lancashire GP and NHS campaigner David Wrigley described the plan as “hugely worrying,” with “many risks attached to it.”2
Cite this as: BMJ 2015;350:h3192
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