Government must follow the evidence before implementing seven day GP services

The government should ensure that there is a real demand for weekend access to general practice before imposing seven day services nationally, MPs have said.

In a wide ranging report on primary care1 the health select committee said that there needed to be a full evaluation of the pilot programmes—that tested the provision of routine weekend appointments—“before any new system was rolled out around the country.”

The report continued, “The government’s approach should be evidence based, learn from best practice, and avoid unintended consequences such as damaging weekday services, continuity of care, or existing urgent out of hours primary care services.”

The government included a commitment to broadening access to GP surgeries in its manifesto, and set up pilot programmes in 2013 to test weekend and evening appointments.2 However, there were questions over whether there was demand for GP services at the weekend: a pilot scheme in North Yorkshire closed last year after it found little appetite among patients.3

Sarah Wollaston, former GP and chair of the committee, said that it welcomed the goal of improving access for patients who cannot attend their GP practice during the week.

But she added, “Practical application of the seven day policy should be locally designed and led by the evidence. It should take account of local recruitment challenges and the potential impact on continuity of patient care as well as the capacity of weekday services and any unintended consequences for urgent out of hours primary care cover.”

The report said that difficulty accessing primary care was a “serious concern” for many patients and that timely access was vital. “This includes both access to urgent appointments and the ability to book routine appointments in advance,” it said.

The committee also raised concerns over variations in quality of care in general practice and highlighted the role of the Care Quality Commission in driving up standards. It rejected calls from both the BMA and the Royal College of GPs to scrap the regulator, instead urging them to work constructively with it.

However, Wollaston added, “We also recognised the need to reduce the bureaucracy faced by GPs so that time which should be devoted to patient care is not eroded.”

The committee also said that the government should recruit and retain not only more GPs but other health professionals including physiotherapists, nurses, and pharmacists. It also supported the recruitment of physician associates but acknowledged that this would be a “more challenging proposal from a purely clinical perspective than attempting to embed the presence of physiotherapists and pharmacists.”

It said that the roles and responsibilities of physician associates would need “careful evaluation,” and attention should be paid to their continuing professional development.