- Fewer than a fifth of surgeries offer evening and weekend appointments
- When patients do get out-of-hours slots they are seeing 'unfamiliar' doctors
- Government has pledged to offer nationwide out-of-hours care by 2020
Tens of millions of patients still cannot see a GP out of hours despite a major drive for longer opening times.
Fewer than a fifth of surgeries in England offer appointments during evenings and weekends, NHS figures reveal.
And patients lucky enough to live in areas where out-of-hours slots are available are almost always seen by an unfamiliar doctor.
Most practices running ‘extended access’ schemes are part of local groups where only one stays open beyond normal office times.
The figures will fuel concern the Government pledge to offer out-of-hours appointments nationwide by 2020 is wildly off course.
Ministers have repeatedly promised to extend surgery hours in the hope of preventing rising numbers of patients going to A&E.
But senior GPs oppose the schemes and claim they have neither the funds nor staff to provide more appointments.
Doctors in parts of North Yorkshire and Hertfordshire who were initially offering weekend slots have since abandoned them, claiming patients were not showing up.
Campaigners said the figures were of ‘significant concern’ and warned the shortage of out-of-hours slots was creating huge pressure in A&Es.
The schemes were announced in 2013 by David Cameron, who promised ‘hardworking people’ would be able to see a GP ‘seven days a week’.
Surgeries were encouraged to apply for extra NHS cash so they could hire additional staff.
Smaller practices were urged to form local groups together called ‘federations’, with one designated as a hub to offer all out-of-hours slots for the area.
But the schemes have been heavily criticised by the Royal College of GPs and the British Medical Association, who claim patients do not want to see a doctor at such times.
They say practices do not have enough money to stay open seven days a week, with many struggling to provide even a nine-to-five service.
An NHS England survey of 7,139 of the 7,459 surgeries in the country found just 18.5 per cent offer ‘full extended access’.
This was defined as providing appointments to their patients for an extra one-and-a-half hours on weekdays – usually until 8pm – and at weekends.
The figures, uncovered by Health Service Journal, mean only 9.86million patients are fully covered out of hours.
Six in ten patients have ‘partial’ extended access to a GP – meaning one evening appointment a week at a surgery somewhere in their area.
NHS England includes these patients in its figures, but critics says this does not fully meet the Government’s pledge.
Katherine Murphy of the Patients Association said: ‘We are disappointed to hear most areas are still falling behind in offering GP appointments at evenings and weekends … if patients do not have access to primary care services they are more likely to attend A&E departments which are already experiencing high demands.
‘Lack of access to GPs is of significant concern. Long waits are unacceptable as some patients may decide not to seek treatment…This may lead to serious illnesses being missed.’
But Professor Helen Stokes-Lampard of the Royal College of GPs said: ‘Extending GP surgery opening hours means taking staff and other resources away from our routine service, which is already stretched incredibly thinly due to years of decline in investment.’
She added that many practices offering services in the evening and at weekends have stopped because ‘patient demand has been so low’.
Richard Vautrey of the British Medical Association GP committee said the scheme was ‘flawed’ and warned some surgeries would have to reduce extended access as the Government had cut funding.
Patients have struggled to get out-of-hours appointments since 2004 after a GP contract negotiated by Labour.
The terms allowed doctors to opt out of being responsible for their patients at evenings and weekends – yet their pay soared to more than £100,000 a year.
The Tories have repeatedly promised to undo the ‘disastrous changes’.
But surgeries are under pressure due to migration, an ageing population and an exodus of GPs. Many have waiting times of more than three weeks.
An NHS England spokesman said it was ‘encouraging to see from these figures that local GP practices, by working together, are offering evening and weekend appointments to the vast majority.
'These figures confirm the best approach for offering extended access is not for each practice to have to do so … but instead to share appointments across practices.’