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Should general practices open for longer?

BMJ 2013; 347 doi: (Published 19 November 2013) Cite this as: BMJ 2013;347:f6832

Re: Should general practices open for longer?

The question ‘Should general practices open for longer?’ [1] does not specify an additional number of opening hours. Similarly, the recent proposal for GPs in England to see patients from 8 am to 8 pm, seven days a week [2] tells us little about how much longer the hours in which GPs provide consultations would become. We therefore analysed data, obtained from NHS Choices [3] on 1st October 2013, on the ‘surgery’ (as opposed to ‘reception’) opening hours for 8,973 general practices in England.

Surgery opening hours currently total 341,857 hours per week; the median value is 40 hours per week. The median for opening hours outside of core hours (8 am to 6.30 pm, Monday to Friday) is 1.25 per week.

If the Government’s proposal was implemented nationally in each general practice, surgery opening hours would total 753,732 hours per week (a 120% increase). Each practice would provide consultations during 84 opening hours (a 110% increase over the current median), and 31.5 hours outside of core times (as defined above; a 2,420% increase), per week. Only 70 practices (0.8%) are open for 84 or more surgery hours per week currently; 83% of practices are not open at all at the weekend.

The results help to estimate the scale of the proposed intervention if implemented nationally and suggest significant financial and staffing implications. However, surgery opening hours may be a less informative measure than the number of hours of consultation provided per week (as, for example, two GPs could provide two hours of consultation within one opening hour). Does the Government intend to increase the number of consultation hours per week, in addition to extending surgery opening hours?

In the GP Patient Survey 2012-13, [4] 89% of respondents (Q12; n=907,732) indicated being able to get an appointment to see or speak to a GP or nurse on their last attempt, and 92% of this group reported the appointment as convenient. Additional consultation hours could help to meet the remaining, unmet demand; though this will not necessarily reduce the occurrence of A&E attendances, and the possibility of supply induced demand is also present.

1. Kingsland JP, Swinyard PW. Should general practices open for longer? BMJ 2013;347:f6832. doi: 10.1136/bmj.f6832.

2. U.K. Government. Seven day, 8am - 8pm, GP access for hard working people.

3. NHS Choices.

4. Ipsos MORI. Technical Annex for the GP Patient Survey: 2012-13 Annual Report. 2013.

Competing interests: No competing interests

29 November 2013
Thomas E. Cowling
NIHR Doctoral Research Fellow
Matthew J. Harris, Michael Soljak, Azeem Majeed
Department of Primary Care and Public Health, Imperial College London
London W6 8RP