All over social media recently there has been wailing and gnashing of teeth by GPs, such as myself, at suggestions that the opening hours of general practice are in some way to blame for the crisis in hospitals up and down the country. A single paper initially led with the story that the Prime Minister was going tell GPs that they had to be open from 8 until 8, 7 days a week, according to local need. This is nothing new. This is old news. This is the part of the plan set out in the GP Forward View, with the finer details being laid out in NHS operational planning guidance (see page 53).
Fortuitously for the government the National Audit Office has recently released a report into GP opening times. This shows that, currently, GP practices are not open 8 until 8, and in fact some surgeries will have a half day, neglecting to point out that many surgeries will compensate for this by opening during unsociable early or late hours on other days of the week.
Certain aspects of three reports have simply been juxtaposed, within a right wing newspaper and set alongside the context of the bed crisis in the NHS. The ridiculous inference is that the crisis seen in hospitals is down to GP surgery opening times. However, the Prime Minister hasn’t even made an official statement, speech, or given a press release about this—all that is reported is that she is going to remind GPs of the details of the GP Forward View.
As always, the politicians, their advisors, and journalists have cherry picked from the reports linked above, in order to create a distracting media storm. Better to have irate GPs, and their supporters, on the TV and social media, than pictures of patients in corridors and stories of deaths on trolleys. The spin doctors have done a perfect job and we have all fallen for it. The Prime Minister doesn’t even have to retract a statement she hasn’t made.
As for the cherry-picking—well the GP Forward View and the accompanying operational guidance make it clear that not every practice will have to work from 8 until 8, 7 days a week. Practices will be able to work together. The National Audit Office report does talk about the current state of affairs, but the real headline from it is that every unsociable hour that a GP surgery opens will cost 50% more than regular office hours. It is also worth pointing out that we’re in Year One of the GP Forward View, which is underpinned by the Five Year Forward View. The clue is in the name of the latter. GPs are not expected to provide these extended hours services until 2021, so no wonder current opening hours are much less.
Organisations that have been quick to jump into the media to decry a statement that has been reported will be made, are the very organisations that support the GP Forward View; namely the British Medical Association and the Royal College of General Practitioners. They think it will be the only way that general practice will get the funding it needs.
The argument over whether the GP Forward View makes economic or clinical sense is one that needs to be had. The real debate for the moment, however, is about the crisis in the NHS as a whole due to a combination of funding, workforce, and demand issues. All three have to be tackled at the same time to have any hope in hell of providing the public with standard of care they need.
This blog also appears on Samir Dawlatly’s personal blog site.
Samir Dawlatly is a GP partner in Birmingham, a Board Member of Our Health Partnership and co-clinical director of QCAPS for Northfield Alliance Ltd. The views expressed here are his own and don’t necessarily represent that of any organisation he works for.
Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: I am a GP partner at Jiggins Lane Medical Centre and managing partner and board member of Our Health Partnership. I am the co-clinical director of the QCAPS referral management scheme for Northfield Alliance Ltd. The views expressed here are my own and don’t necessarily represent those of any organisation I work for. I am an occasional member of the RCGP online working group on overdiagnosis.