'Your doctor won't see you now'

Health chiefs say a new service means every single person can arrange to see a doctor in the evening and at weekends but they face having to travel to one of three centres in Blackpool, Fleetwood or Freckleton.

And figures reveal there are still more than 100,000 people on the Fylde coast not getting the full service pledged back in 2014 at their own GP surgery.

Patients were promised they would soon be able to book doctors’ appointments in the evening, at weekends and before the working day started in order to fit in with increasingly busy lives.

But now our investigation reveals just 68 per cent of patients – 221,600 people – on the Fylde coast are getting the full extended access, intended to allow them to pre-book appointments from 8am and after 6.30pm on weekdays as well as at the weekend, from their own doctor.

Another 22 per cent have some access to their GP out of hours – but only on selected days – and one in 10 still have no extended access at all. Some of those face a long journey to get to either the Whitegate Health Centre, Freckleton Health Centre or Fleetwood Health and Wellbeing Centre, which provide the service to more than 300,000 patients on the Fylde coast.

The figures also show the post code lottery for people living in Lancashire, with huge variation in the level of service offered both within the county and nationally.

Surgeries in the Fylde coast’s two clinical commissioning groups (CCGs) have some of the highest rates of full extended access provision in Lancashire. Only Blackburn with Darwen, at 90 per cent, has more.

While all Fylde and Wyre patients have at least some access to out of hours appointments with their own doctor, there are 31,026 - 18 per cent – in Blackpool with no extended access at all. Across the county, only East Lancashire has more - 22 per cent.

While both Fylde coast CCGs are above the national average when it comes to full extended access, Blackpool is in the bottom 25 per cent when it comes to those with no access at all.

The extended access was not intended for emergencies, but for people to be able to make routine appointments with their GP without taking time off work.

Patients in Lancashire generally fare worse than many boroughs in London and the South East, where almost all surgeries offered the provision.

In total there are 24 out of 207 areas – including Blackburn – where more than 90 per cent of patients have full access to extended opening.

The numbers

The statistics have been collected by the BBC’s Shared Data Unit and analysed by The Gazette. They are sourced from data provided by NHS in England, Scotland and Wales.

The data is collated bi-annually from surveys filled out by individual GP practices.

It found 41 per cent of GP practices in England offer full provision for extended access, with 40 per cent of patients were registered at a practice offering full provision to extended access.

NHS England said its own analysis shows out of hours access now stands at 55 per cent nationally but did not provide the data this was based on.

What is extended access?

Appointments are defined as scheduled slots with a GP, nurse or other member of general practice staff providing direct patient care.

Appointments must be pre-bookable.

In England, ‘extended access’ is delivered by CCGs through individual GPs practices or through hubs or federations.

Full provision means patients have access to pre-bookable appointments on a Saturday and Sundays and on each weekday for at least 1.5 hours in the early morning from 8am and in the evening after 6.30pm through the practice or a group of which the practice is a member.

Partial provision means patients have access to pre-bookable appointments on at least one day a week, through the practice or the practice group, but the extended access offered is not sufficient to meet the criteria of full provision. The minimum provision to meet this criteria is 1.5 hours once a week.

Not enough doctors

The situation on the Fylde coast is made more complicated by a lack of doctors.

While the Government wants surgeries to offer extended access to all patients, many in the profession say money would be better spent improving core services.

Earlier this year, The Gazette reported retiring doctors were being offered £20,000 a year to stay on in a bid to avoid a shortage.

Despite already having one of the lowest rates of GPs relative to the population size, in January it was revealed more than one in five of the resort’s 92 family doctors was due to retire in the next five years.

Meanwhile two surgeries have already been forced to shut in recent years due to difficulties replacing doctors – and the Glenroyd Medical Centre revealed it was struggling to maintain its patient boundary due to a shortage of GPs coupled with a rise in patients.

National Picture

A Department of Health spokesman said: “We want everyone to have access to GP services, including routine appointments at evenings and weekends - and already millions of patients have benefitted from this which is backed by our investment of an extra £2.4 billion a year into general practice by 2021.”

The Shadow Secretary of State for Health and Social Care, Jonathan Ashworth MP said: “This is yet more evidence that the Tories have broken their promises on access to GPs seven days a week.

“The truth is that years of austerity has taken its toll on general practice. We need a serious long term investment plan for primary care.”

The British Medical Association’s, GP committee chairman, Dr Richard Vautrey said: “While schemes like this (extended access) are rolled out and are successful in providing the services they are commissioned to do, we still believe the money invested in such programmes would be better spent improving core GP services.

“We know that patients are frustrated with being unable to get timely appointments during regular working hours, owing to increased demand and unmanageable GP workloads, and therefore it is these services that should be a priority for proper funding.”

Dr Tony Naughton

Speaking on behalf of the Fylde Coast NHS, Dr Tony Naughton, clinical chief officer at NHS Fylde and Wyre CCG, said: “Everyone registered with any of the 38 GP practices on the Fylde Coast has access to GP appointments in the evenings and at weekends.

“Operating from sites in Freckleton, Blackpool and Fleetwood, the extended access service offers pre-bookable and same day appointments with GPs, nurses and other healthcare professionals at times convenient to those who struggle to get to their practice during the working day.

“To book one of these appointments, ask your GP practice receptionist about the extended access service.”

David Blacklock, CEO of Healthwatch Lancashire, said: “Many of us have commitments in our everyday lives which impact our ability to access health care within normal working hours – work, childcare etc – meaning the need for services to be more patient-centred has never been greater. “The Government made a commitment to enable people to access care when they need it. This clearly is not reflected in people’s experiences. He added that CCGs locally are “still some way short of the Government target of 90 to 100 per cent provision”.

“NHS leaders must ensure that the views of patients are taken into account as they shape and improve services and clearly must do more to make these services responsive to patient needs,” he said.