Extending GP hours to reduce A&E attendance

Barking and Dagenham, Havering and Redbridge CCGs contacted us because of high levels of attendance at A&E for patients with primary care needs, coupled with low patient satisfaction with access to general practice.

The aim of the Prime Minister’s Challenge Fund bid was to deliver improved access to general practice through a contract with the GP federations. At the time of winning the bid, the emerging federations were not yet in position to hold an NHS contract and deliver the services described in the bid and the timescale for implementation of the project was very challenging.

We provided expert primary care support to the CCGs in the following areas:

  • Preparing the NHS standard contract for signature by providers and the CCGs
  • Facilitating the smooth transfer of the contract to the GP federations once they had achieved CQC accreditation.
  • Supporting the identified provider to prepare for the delivery of the service
  • Monitoring and developing ideas for increasing the utilisation of the service
  • Developing a strategic framework for primary care

Three “access hubs” were opened, delivering urgent out of hours primary care appointments. A flexible approach to the service enabled rapid changes to the service specification, including extended opening hours and additional access points. The hubs were able to provide considerable additional capacity during the Christmas and New Year period.

Over 23,000 new GP appointments created

The bid resulted in a contract being awarded, which was successfully transferred to the federation within three months of the service opening. Patient feedback indicated a high level of satisfaction with the new service.

In its first eight months, 23,283 additional appointments were created across the CCGs and minor self-presenting A&E attendance went down by 7%.