- Patient numbers fall from 8.6million in 2007-2008 to 5.8million last year
- More than a quarter of those surveyed said they didn’t know about service
- Said they would go to AE instead, increasing workload for hospitals
- Handling non-urgent cases this way can boost ratings and finances
- Labour initiative allowed GPs to opt out of providing out-of-hours care
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The number of cases handled by out-of-hours GPs has plummeted by a third in only six years, according to a critical report.
They dealt with 5.8million patients during the evening and at weekends in the past year, compared with 8.6million in 2007-8, despite the ageing population and rising patient numbers.
More than a quarter of the people surveyed said they had no idea they could even see their doctor out of hours, and that they would instead go to AE for treatment, or call 999.
The number of out of hours cases seen by GPs has plummeted from 8.6million in 2007-08 to 5.8million last year, with patients heading to AE departments instead, increasing their workload
Of the 5.8million cases, only 800,000 were classified as ‘home visits’, fewer than one in seven of all cases handled, the National Audit Office research found.
The report attributes some of the drop in cases to millions phoning the non-emergency 111 number – but said this was only a partial explanation and that out-of-hours provision needed to improve urgently.
Of those patients who used out-of-hours services, two thirds said they were ‘very good’ or ‘fairly good’ but a third of respondents – nearly two million nationally – were unhappy with them.
The NAO report said NHS England, the central authority, ‘lacks the necessary information to assess the relative riskiness or adequacy of different out-of-hours GP services’.
It found that many local NHS teams did not do any monitoring of the quality and value for money of their out-of-hours services – despite being ordered to by NHS England last year.
As a result, patients were choosing to go straight to busy AE departments, which increases their workload.
But the report accused some health trusts of not wanting out-of-hours services to take on more patients.
In a perverse incentive, handling non-urgent cases in hospital could boost a trust’s finances and performance ratings.
The survey found that 26 per cent of people had not heard of out-of-hours services.
Study by the National Audit Office found that a quarter of patients didn’t know GPs were available out-of-hours, while a third of those who had used the service were unhappy with it
Nineteen per cent had not heard of the NHS 111 number and 11 per cent who had heard of it did not know what it was for.
Young people were least likely to have heard of out-of-hours GP services (43 per cent had not come across them) followed by those from ethnic minorities (50 per cent).
In 2004, in a much-criticised move, GPs were allowed to opt out of providing evening and weekend cover by the last Labour government and to pass on the responsibility to the NHS or a private provider.
Separate research from the GP Patient Survey last week found that even among those who had heard of out-of-hours services, 44 per cent did not know how to contact them – including many with long-term conditions who could benefit from being seen out of office hours.
Amyas Morse, head of the NAO, said: ‘Although some clinical commissioning groups are achieving value for money this is not the case for the commissioning of all out-of-hours GP services.
‘NHS England has much to do to secure improvements throughout the system.
‘It should also work to increase public awareness of how and when patients should contact out-of-hours GP services.’
Jamie Reed, a Labour health spokesman, said: ‘In the fifth year of David Cameron’s government, he should be ashamed that one in three patients aren’t satisfied with out-of-hours care.
‘The report is right to warn that uncertainty over these services drives patients towards hospital AE departments that are already struggling with record numbers of patients this summer.’
Damning NHS research into more than 900,000 people last week found that patients were losing faith in their GPs, with a quarter having to wait at least a week for an appointment. One in ten said they had given up trying.
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somebody,
some where, United Kingdom,
1 hour ago
I have been puzzled for some time, as to why I cannot get an appointment on the day, even if I ring up at 8AM. I have now realised the appointments are being booked up in advance on line. This means there are about two, maybe three appointment times left each day. First come, first served, then it’s just hard luck.
Dr William,
Worcestershire,
9 minutes ago
compass_rose,
Leeds, United Kingdom,
9 hours ago
Nevertheless these are legitimate questions for a taxpayer to ask. Is there a correlation here? Why is a service that recieved a vast injection of revenue 10-15 years ago now unable to carry on without more money. It seems that costs have exploded and the level of service has atrophied. (GPs of the time didn’t know why they were being given this extra money and many said they didn’t need it) When considering the performance of an almost wholly personal service delivered by people, it is legitimate to ask questions of those people if things sound like they don’t add up.
Dr William,
Worcestershire,
7 minutes ago
Sick note,
That would be the sack, United Kingdom,
9 hours ago
As a paramedic we are seeing more patients than ever that should be using the general practice inside and outside normal hrs and not using 999 as their default setting for not bring well. I personally do not transport nearly 70% of the patients I attend on emergency calls and I refere to other pathways of care. Bouncing patients back to gp ooh service is a nightly occuracne and several times too.
greatscot,
wells, United Kingdom,
10 hours ago
I think GPs really don’t like having to deal with the elderly or sick individuals and would, ideally, like to work just three days a week…….!!!
mouch,
lancaster,
10 hours ago
It took from about 10 am to early evening to get a Dr 111 was useless and finally had to call 999 Ambuklance crew were excellant and insisted that a Dr be sent when he arrived wife told him it was no laughing matter, he could not prescibe treatment as he wasn`t daughter`s Dr but did contact her Gp later and he arrived nid morning and made arrangement for ambulance and Hospice after hospital. ot took around 6 hours waiting at hospital for a bed and there were ambulances queing to hand over patients left in a room with no medical staff – fortunately my wife was there as my daughter started being sick again. The surgery y is only open 5 days except when they have a `training half day and then only open 4 1/2 days vote for who now,
Johhanes,
Glasgow, United Kingdom,
12 hours ago
The day is coming when no one will have a GP to go to, especially the sick and unemployed as the Tories want rid of what they see as unproductive stock.
Justin Smith,
London, United Kingdom,
12 hours ago
This is a problem with the public secytor: money and salaries guaranteed and managers can do almos what they like
intrepid001,
Ipswich, United Kingdom,
13 hours ago
And, this is why AE departments are full of people who should be seen by a GP, a General Practitioner, and not any form of specialist care UNLESS AND UNTIL a diagnosis is reached that real medical care is paramount. Time to site SOME GP surgeries in the same grounds as hospitals so that the first port of call would be GPs in a building separate to AE departments. In addition, and whether we like it or not the GP system is increasingly female, at the last count, some 3 months ago, 51% of all GP are women and many choose to work part-time, for one reason or another and others ONLY during term-time and during school hours. That system is NOT a GP medical system and time it was over-hauled.
malc,
Essex,
13 hours ago
The article is about the out of hours service and not GP’s day time service. The out of hours service is underfunded but is subject to CQC inspections and they have the power to shut them down if they do not perform. Not likely to get more money for this as have to fund gastric bands for the fat.
ColP,
Ware,
14 hours ago
Half the time the problem rests with the receptionist, who will deflect requests for an appointment where possible, by asking if the problem really needs a doctor ? This can be followed by an an inquisition regarding the symptoms, before deciding whether you really do need any treatment should be allowed to have a consultation or go away take an aspirin.
Is a receptionist allowed to have full knowledge of your medical condition ? I was under the impression that was something that my doctor no-one else was entitled to know.
mouch,
lancaster,
10 hours ago
Heavenhelpus,
London, United Kingdom,
6 hours ago
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