Seven-day GPs slash casualty admissions by a fifth at weekend
KEEPING GP surgeries open at weekends reduces patient visits to A&E by nearly a fifth, researchers said yesterday.
Experts at Sussex University found that when people were able to get into their local health clinic on Saturdays and Sundays, fewer of them visited hospital emergency departments.
The results support the Government’s plan to enable all patients to see their GP seven days a week by 2020.
The study, based on a pilot project at GP surgeries in London, found that when clinics stayed open seven days, visits to A&E units at local hospitals dropped by 10 per cent across the week. The greatest effect was seen on Saturdays and Sundays, with an 18 per cent drop.
Those patients who did go to hospital were less likely to be admitted and ambulance callouts also dropped by 20 per cent.
The reductions were mainly among elderly patients with moderate injuries or illnesses.
Reproduced nationally, the results would significantly reduce pressure on hospitals.
The Government is desperate to find a way to reduce the pressure on A&E services, after the busiest year in NHS history. Nearly 23million patients went to A&E in the last 12 months – a 32 per cent increase on figures from a decade ago.
But its ambition for seven-day GP services faces two major hurdles – a serious shortage of GPs across the country, and the opposition of the doctors’ union.
The British Medical Association claims the plans are unfunded and unresourced and that, if they are forced to open all weekend, many GP surgeries will simply stand empty. They point
‘Keep mild cases out of hospital’
to similar pilot schemes, in Yorkshire, where barely one in ten appointments were filled on Sundays and only half on Saturdays.
BMA chairman Mark Porter also points to a huge shortage of GPs, with thousands more expected to leave the profession in the next five years. Labour’s 2004 GP contract has been blamed for increasing numbers of patients flooding A&Es with minor complaints. It allowed GPs to opt out of evening and weekend work – leaving patients with nowhere else to go
The authors of the new research, published in the Journal of Health Economics, said GPs are ‘gatekeepers’ who keep mild cases out of hospital.
The researchers believe A&E doctors take fewer risks with elderly patients they do not know and choose to admit them to a ward to be ‘on the safe side’.
But GPs with intimate knowledge of their patients’ medical history can send the less serious cases home after treatment. Researcher Dr Vikram Pathania, of Sussex’s School of Business, Management and Economics, said: ‘There is clearly evidence of unmet demand for weekend GP opening. Seven-day opening for GPs appears to make a dent in two major sources of A& E expense – admissions and ambulance usage.
Dr Richard Vautrey, deputy chairman of BMA’s GP committee, said: ‘It should be noted that schemes such as this have only been possible through significant additional, short- term funding.’
A Health Department spokesman said: ‘This research is promising and exactly why we want to promise the people of this country a safer, seven-day NHS’.