Press release: NHS Confederation says health service needs a more comprehesive approach to access
08 May 2008
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A briefing published by the NHS Confederation - which represents over 95 per cent of NHS organisations - states that the health service must consider the wider issues in improving primary care services as part of the drive to improve access to general practice.
While changes to the GMS contract have provided PCTs with the tools to better negotiate extended hours services, it is crucial that the NHS improves the quality and responsiveness of services as well as hours of access. Consultations with GPs make up half of all daily contacts with the NHS and satisfaction rates with primary care - particularly GP services - are impressive. However, ratings vary across the country, and the NHS Confederation's Primary Care Trust Network believes more can be done to ensure patients receive a consistently high quality of care. This includes tackling health inequalities, increasing the choice and standard of services, and finding out how patients want to use their local services.
Tackling heath inequalities - it is estimated that millions of people are not accessing the services they need when they need to, or have conditions such as diabetes or lung diseases that remain undiagnosed. We need to find the missing patients and help them use local services. Also, satisfaction rates for services vary substantially between different groups of patients, particularly across different ethic groups. It is important identify and fully understand the causes of disparity in access to primary care across different groups.
In order to tackle health inequalities, the right incentives must be in place. The Minimum Income Practice Guarantee was introduced to make sure GPs did not lose out under the new contract in 2003 and provide transitional financial support to doctors. However, around 95 per cent of practices still receive some form of MPIG payment, which costs around £600 million every year. Practices in deprived areas traditionally lose out under this system, which also does not provide enough incentives to doctors to extend their practice lists to more patients, as they receive a minimum payment regardless of the amount of patients they see. The NHS Confederation briefing puts forward the view that MPIG should be abolished. However, it is crucial that this should be phased out gradually in a planned way, to make sure any reduction of income to practices is carefully managed and maintain stability.
Increasing the choice and standard of care - competition can help to improve the quality of GP services, and encourage practices to offer a wider range of services and extended opening hours, as well as building capacity. Patients want information to support their choices, and publicising GP performance ratings at a local level could help encourage people to make more use of them. The Primary Care Trust Network believes we need to remain focused on improving the quality of services offered to patients, as well as the ways these services can be accessed.
Improving the ways patients can use local services - some eight million people are not happy with their current GP opening hours (GP Patient Survey 2007) and this is clearly an important issue, but there are other areas of concern. A quarter of patients are dissatisfied with booking appointments in advance. Online booking provides a potential and often popular solution. Telephone consultations, electronic prescriptions, community pharmacy can also help make services more accessible. Trusts are working to find out what local people want and what their priorities are - whether this is opening hours, the range of services provided, or walking distance to practices.
David Stout, Director of the Primary Care Trust Network says:
"We need to look closely at what stops patients assessing services and consider their priorities in seeking NHS treatment. It would be short sighted to focus solely on extended hours and when there are many wider issues in making sure patients get high quality of care they need. It is important to ensure resources get to the practices that need them the most - money should follow the patient. Our briefing highlights that challenges around primary care access go beyond practice opening times. We must consider all elements of access in its wider sense."
For more information on this publication or the work of the NHS Confederation please visit www.nhsconfed.org
ENDS
Notes for editors
- The PCT Network represents all primary care trusts in England. It was established in December 2006 to provide a distinct voice for PCTs. The Network is part of the NHS Confederation. Please see attached the publication Access all areas: improving GP and primary care access.
- The NHS Confederation represents more than 95% of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.