By Richard Johnstone | 11 July 2014
Out-of-hours GP services are not achieving value for money across the country, auditors have warned, with around a quarter of people unaware the services exist, leading to extra pressure on accident and emergency departments.
In an analysis of out-of-hours GP services, which provide urgent primary care when GP surgeries are closed, the National Audit Office said the number of cases handed has fallen significantly in recent years, from an estimated 8.6 million in 2007/08 to 5.8 million in 2013/14.
As a result, out-of-hours GP services cost less now, in real terms, than they did in 2005/06, although the establishment of the NHS 111 phone line makes cost comparisons difficult. It was estimated that out-of-hour services cost £400m in 2013/14.
According to a survey commissioned by the NAO, 26% of people had not heard of out-of-hours GP services. Awareness among certain groups, including younger people and people from black and minority ethnic communities, was lower than among others.
People who were not aware of services were more likely to go to under pressure A&E departments if they or their family feel unwell during the night or at the weekend, today’s Out-of-hours GP services in England report stated.
Auditors also concluded that NHS England did little in 2013/14 to assure itself of the quality and value for money of out-of-hours GP services.
Although the body told its 27 local area teams to seek assurance in March 2013 about these services from clinical commissioning groups, which commission most services, it did not give guidance about how to do this until a year later.
Auditor general Amyas Morse said that although some CCGs were achieving value for money, this is not the case for the commissioning of all out-of-hours GP services.
‘NHS England has much to do to help secure improvements throughout the system and to increase its oversight of the out-of-hours GP services it commissions directly.
‘It should also work to raise public awareness of how and when patients should contact out-of-hours GP services, and needs to be prepared to take the lead in integrating these services effectively with other parts of the urgent care system.’
An NHS England spokeswoman said: ‘We are confident that the new out-of-hours assurance process brought in earlier this year (March 2014) is robust and has addressed many of the issues outlined by the National Audit Office. We will however carry on developing processes to ensure patients continue to receive high quality care and access to a GP outside of surgery hours.’
