Patients struggle to get GP appointments

Apr 25 2008 by Madeleine Brindley, Western Mail

PATIENTS are struggling to get a GP appointment in practices in parts of Wales as surgeries are closed for large parts of the week.

A mystery shopper-style survey of more than 90 GP practices in Gwent found access to appointments was “exceedingly limited”.

And Gwent Community Health Council, which carried out the work, has raised concerns patients are using busy A&E departments, or out-of-hours services, because they can’t see a GP.

The survey, which is published today, found large numbers of practices are routinely closed for half a day and many surgeries are taking three-hour lunch breaks. In some cases patients had to wait a month to get an appointment.

It is not clear whether the findings are representative of Wales as a whole, but they appear to contradict previous nationwide surveys which showed patients are happy with access.

And they run contrary to the belief the GP contract, which was introduced in 2004, has helped to improve access for patients.

The British Medical Association Wales today said it would not condone poor practice.

The Gwent CHC findings reveal large numbers of GP surgeries are failing to meet the Welsh Assembly Government’s accessibility targets of offering patients an appointment within two weeks.

And it revealed many practices offer far less than the minimum threshold of 20 hours’ of patient appointments a week.

The Gwent CHC report said: “We know that when the GP out-of-hours service becomes available at 6.30pm there is a surge in demand. Is this because out-of-hours services are more accessible than in-hours?”

It added: “The lack of availability of primary care during the working day raises concerns patients who cannot access a timely appointment with their GP are turning to other services, such as out-of-hours and A&E departments.” Cathy O’Sullivan, Gwent CHC’s chief officer, said: “We do regularly receive concerns from the public about the availability of GPs and the length of time people have to wait for routine appointments. Our survey does confirm there are issues of access across Gwent. I believe the findings of will resonate with many patients and start a much-needed debate.”

The survey also found some surgeries in Gwent, which covers Torfaen, Monmouthshire, Blaenau Gwent, Newport and Caerphilly, have no GPs who work after noon. Of the 93 practices contacted by the CHC’s “mystery shoppers”, 45 closed half-day at least once a week, even though they no longer open on Saturday mornings.

The Gwent CHC report said: “At present the pattern of delivery of primary care would seem to fly in the face of government initiatives to encourage people back to work and begs the question, shouldn’t the culture of primary care be changing to reflect modern-day working practices and consumer expectations?”

Dr David Bailey, chairman of the Welsh GPs’ committee, said: “If this is a genuine reflection, there are areas of the service that we cannot condone. We expect local health boards to look into how accurately this reflects the situation and where there are significant problems, then LHBs and practices need to address them.”

Jonathan Morgan, the Welsh Conservatives’ Shadow Health Minister, said: “My concern is if this is happening in Gwent it could be repeated elsewhere in Wales.”

And Jenny Randerson, the Welsh Liberal Democrats’ health spokeswoman, said: “It is a realistic expectation that people should be able to get an appointment when they need it and the solution has to be in a more flexible set of health services, rather than in the more rigid services we have got as a result of the GP contract.”

Health Minister Edwina Hart is now considering the report.