Intended for healthcare professionals


Evidence and rhetoric about access to UK primary care

BMJ 2015; 350 doi: (Published 31 March 2015) Cite this as: BMJ 2015;350:h1513
  1. Thomas E Cowling, National Institute for Health Research doctoral research fellow1,
  2. Matthew J Harris, Commonwealth Fund Harkness fellow in healthcare policy and practice12,
  3. Azeem Majeed, professor of primary care1
  1. 1Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
  2. 2Department of Nutrition, Food Studies, and Public Health, New York University, New York, USA
  1. Correspondence to: T E Cowling t.cowling{at}
  • Accepted 5 March 2015

As the general election in the UK approaches and NHS policies are set to take centre stage, Thomas E Cowling, Matthew J Harris, and Azeem Majeed discuss the evidence, uncertainty, and debate behind access to primary care

Access to general practice is a prominent issue in national policy debate ahead of the 2015 UK general election in May. The two main parties, Conservative and Labour, have both made bold pledges on this topic. However, the problem with access has not been precisely defined; nor has the evidence behind pledges been made clear. Below we discuss the evidence on problems with access and whether the party promises are likely to be achievable.

Party pledges

The prime minister has declared that everyone in England will be able to see a general practitioner between 8 am and 8 pm, seven days a week, by 2020 if the Conservative Party is re-elected to government.1 A £400m (€538m; $610m) commitment to implement the policy nationally follows a £50m pilot in about 14% (1147) of general practices.1 2 Results from independent evaluation of the pilot are yet to be published. The government also plans for an extra 5000 GPs and spending an additional £2bn on the frontline of the English NHS next year (currently there are 40 000 GPs and spending is £115bn).3 4

The Labour Party aims to guarantee a GP appointment within 48 hours—a policy recycled from past Labour governments.5 A pledge to invest an extra £100m in primary care a year was followed by the promise of a £2.5bn fund for use across the NHS.5 6 Labour also intends to recruit 8000 more GPs.6 The Liberal Democrats also plan to improve access to general practice (partly through longer opening hours),7 but their pledges are more reserved.

With …

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