Access to general practice in England: time for a policy rethink.

Abstract

Improving access to general practice is one of the current priorities of healthcare policy in England and offering patients timely access is central to this agenda. A £50 million ‘Challenge Fund’ to support pilot initiatives offering GP appointments earlier and later in the day was set up in 2013 and a further £400 million has now been pledged to expand this programme. British Prime Minister David Cameron has promised that patients will be able to see a GP 7 days a week from 8 am to 8 pm and his Health Secretary Jeremy Hunt has outlined plans to recruit an additional 5000 GPs to make this possible.1,2 The Government believes that this policy will reduce admissions to accident and emergency (A&E) services.3 However, its approach is not based on any detailed evidence that there is a strong link between access to general practice and recourse to A&E.4 It also involves privileging a particular dimension of access to general practice over others. This article explores how policy came to be dominated by concerns about speed and convenience, and calls for a wider debate that incorporates other aspects of access. Access to general practice can be described as having three main components:5 If this definition is borne in mind, it would be logical to conclude that policy aimed at improving access would involve addressing these different dimensions of care …