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Since 2013, here at NIHR CLAHRC Greater Manchester, we have been working with the Greater Manchester Health & Social Care Partnership (GMHSCP) to evaluate the implementation of 7 day access to general practice (i.e. additional provision of GP appointments on evenings and at the weekend) across Greater Manchester (GM).
Today (16/10/18) we release the report of our latest research evaluation examining the roll-out of 7 day access across GM, as part of GMHSCP’s commitment to ensuring that “anyone living in Greater Manchester who needs medical help will have same-day access to primary care services, supported by diagnostic tests, seven days a week.” This local priority is reflected at a national level by NHS England’s commitment to ensuring that “by 2020, everyone has access to GP services, including sufficient routine appointments at evenings and weekends”. Our latest evaluation explored the uptake of weekday evening and weekend appointments, how extended access was rolled out and implemented across six GM Clinical Commissioning Groups (CCGs) and the impact it had on the use of other services in the area.
We observed that each area chose to design and implement 7 day access in a different way, depending on local conditions and varying conceptions of the nature and extent of the service. Areas also varied in terms of the scale of implementation, the extent to which the service was publicised, the route of referral/booking, the number and location of hubs, the choice of clinician to staff the service and total provision of appointments. As a result, the evaluation has generated a substantial amount of learning that can be used to inform implementation of 7 day access to primary care in other locations across the country, as well as to help refine the service models already in place across GM.
Professor Damian Hodgson, academic lead for the NIHR CLAHRC Greater Manchester’s Organising Healthcare Programme said:
“This evaluation looked at six CCG areas in GM that, over a 12 month period from December 2015, provided almost 50,000 additional weekday evening and weekend appointments. We explored the activity, processes and outcomes associated with implementation of 7 day access, enabling us to generate significant learning which will be invaluable to other areas designing and implementing such services. Our evaluation, for example, sheds light on the extent to which appointments are taken up, who they are used by and how utilisation varies by day of the week and changes over time. It also explores the factors that influence how 7 day access services are designed and implemented, such as the location of hubs, as well as identifying a number of key issues to consider when putting these services into operation.”
The GM Health and Social Care Partnership, (GMHSCP) used these findings to further refine the seven day access offer across Greater Manchester, and inform ongoing conversations and decision-making about its implementation, ensuring that our services are informed by the evidence and learning from the pilot sites. Greater Manchester has now rolled out 7 day access to the 2.8 million people living in Greater Manchester under our Primary Care Reform Programme. This has resulted in an additional 1500 hours per week of GP and practice nurse time being available to patients across Greater Manchester.