The UK Government’s extended hours initiative has deprived small GP practices, and those in the poorest areas of the country, of millions in funding according to a major Pulse investigation.
Smaller practices find it far more difficult to offer evening and weekend appointments compared to those with a large number of GPs, disadvantaging their patients and reducing their funding by thousands of pounds.
There is also evidence the extended hours policy is widening the gap between rich and poor. Only 61% of urban practices in the highest quartile for deprivation will qualify for the average £18,000 annual payment for providing extended hours, compared with 75% of those in the lowest quartile for deprivation.
Only 44% of one-GP practices and 60% of those with two or three partners are currently offering extended hours, compared to 83% of those with eight or more partners, shows our analysis of 200 randomly selected practices from more than 100 PCTs.
Payments were recycled from other parts of the contract, meaning practices that are not offering extended hours are receiving less funding compared to one year ago.
Official government figures show the proportion of practices not offering extended opening has stabilised at almost 30%.
Pulse’s investigation identifies for the first time specifically which practices are opening longer – based on calls to each practice to confirm extended opening, data on practice size from NHS Choices and indices of deprivation data from the Office for National Statistics.
The location of a practice is also a key factor, says the report. Some 68% of urban practices offer extended hours, compared with 59% in rural areas.
Dr Asad Mubarik, a GP in Rochdale, Greater Manchester, said his ‘semi-rural’ practice could not afford to open longer. “We would make a loss if we did,’ he said, adding practices in deprived urban areas also faced safety concerns. Opening in deprived urban areas can be very scary. I know a GP who was assaulted after work and ended up in intensive care. The number of staff you would have to have working in the evening would be significant.”
A spokesperson for the Department of Health said: “The issue is not the size of practice, their location or the patients they treat – it is whether GPs make the decision to provide extended hours for their patients. In some PCTs, nearly 100% of practices, from singlehanded to large surgeries and in both urban and rural areas, are delivering extended hours.”
Richard Hoey, deputy editor of Pulse, said: “The Government insists that whether a GP practice offers extended opening is purely a matter of choice, but our statistics show that it is much easier for some practices than others. That means some groups of patients miss out twice over, because they don’t get access to longer hours, and neither does their practice receive as much money for their healthcare. What’s worse is that it is often poorer patients who are missing out, and it is they who often find it hardest to take time off work to see a GP.”
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Written by – Christian Nordqvist