20 December 2013

RCGP Response to Seven Day Working Proposals

The RCGP has responded to Professor Sir Bruce Keogh's seven-day working proposals.

Dr Maureen Baker, Chair of the Royal College of GPs, said: "Seven-day working is a good thing in principle - but it can only work if it is properly funded.

"There are questions to be answered about where the funding would come from to implement the proposals being put forward by Professor Sir Bruce Keogh, but it is not an option to take it from general practice when we are already struggling to cope due to chronic underinvestment.

"GPs want to do more for their patients – including providing more weekend and evening services – but this must come hand in hand with more investment in general practice and more GPs. If increased opening hours are not backed up by more GPs and more investment, existing services will be put at risk.

"Over the last ten years, there has been a dramatic diversion of funding from general practice to hospitals - with the result that general practice is being starved of investment.

"GPs now conduct 90% of the NHS contacts for just 8.39% of the NHS budget - the lowest percentage share of the NHS budget for general practice on record.

"Between 2005/06 and 2011/12 (the latest year for which figures are available) the overall NHS budget grew by 18% in real terms, but funding for general practice fell by 8.3% in real terms, despite a growing population and spiralling health costs. Overall, general practice has lost a cumulative figure of £10.2bn over the last eight years.

"This slump in funding is making it more and more difficult for GPs to deliver the services they want to. An opinion poll, conducted on behalf of the RCGP, showed that 71% of GPs expect waiting times to worsen over the next two years due to the drop in funding.

"In response to the decline, the RCGP and the National Association for Patient Participation (N.A.P.P.) have launched a campaign called Put patients first: Back general practice, which is calling for 11% of the overall NHS budget by 2017.

"The GP workforce is already stretched to the limit even with current opening hours. Another recent RCGP poll revealed that many GPs are routinely working 11 hour days with up to 60 patient contacts in a single day. If we are being asked to provide additional evening and weekend care, this will mean there is reduced availability during the week unless the shortfall in GPs in addressed.

"Delivering care 8am - 8pm seven days a week would more than double surgery opening hours. If just one GP were on duty for each of the additional opening hours, we would need around 10,000 more full time GPs across the UK.

"Forcing exhausted GPs to work seven days a week around the clock is not the solution and is not safe for patients.

"Of course, it is important that patients are able to access a GP for urgent needs outside surgery hours and this is generally provided through out of hours GP services. One problem with these services is that in some cases they have been underfunded due to a race to the bottom with contracts going to the lowest bidder. It is important that the Government and NHS England put a stop to this, so that the service can be run by whoever will provide the best quality for patients, which is often local consortia of GPs.

"This would allow GPs to offer shorter waiting times for appointments and more flexible opening hours to accommodate the busy lifestyles of our patients.

"The Prime Minister’s £50 million Challenge Fund is a welcome first step towards making more funding available to support GPs but to roll out these approaches nationally will require much more.

"We call on Ministers across all four governments of the UK to increase funding for general practice as a matter of urgency so that GPs can give patients the care that they want and deserve in their local communities."

Further Information

RCGP Press office - 020 3188 7574/7575/7581
Out of hours: 0203 188 7659


The Royal College of General Practitioners is a network of more than 49,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.