• Bexley CCG sees biggest increase in patients unable to get GP appointments
  • Most improved group on access to appointments was Slough CCG
  • Recruitment cited as most common problem by CCGs

HSJ analysis has identified the clinical commissioning groups with greatest improvements and biggest declines in patient access to GP services over the last three years, following the annual GP patient survey.

As part of the NHS England survey, patients were asked whether they could get an appointment at their GP surgery when they last tried. The percentage of patients who answered “yes” fell by almost 3 per cent between 2012 and 2016.

HSJ has broken down the responses CCGs give to identify the 10 biggest increases and decreases in performance on the question.

CCGs with declining performance most commonly cite recruitment and retention problems as the reason for increases in people not being able to access GP services in their area. CCGs with the biggest improvements most commonly highlighted extended GP access services as the reason.

The table below shows the 10 CCGs with the biggest increase between 2013 (when CCGs were formed) and 2016 in people who answered “no” when asked if they could get a GP appointment when they last tried.

CCGPercentage point change from 2013 to 2016

Bexley CCG


Nottingham North and East CCG


North East Lincolnshire CCG


North Hampshire CCG


West Lancashire CCG


North Kirklees CCG


Barking and Dagenham CCG


Fareham and Gosport CCG


Basildon and Brentwood CCG


Bradford City CCG


North East Lincolnshire CCG said: “There has been an increase in patients accessing GP services in North East Lincolnshire, alongside the issue of GP practices in the area experiencing pressures with regards to GP recruitment.”

Basildon and Brentwood CCG also said it was taking action on issues around recruitment and retention.

Fareham and Gosport CCG, which recently saw some of its struggling GP practices partner with Southern Health Foundation Trust, said: “Since this survey was completed in March 2016, much work has been undertaken to improve patient access to primary care services in Fareham but particularly in Gosport, where there have been particularly issues around GP recruitment.”

Kathryn Hilliam, head of primary care co-commissioning at NHS England West Yorkshire and Jackie Holdich, head of primary care for North Kirklees CCG, said: “In North Kirklees we have seen an increase in patients accessing GP services and coupled with this, GP practices have also been experiencing pressures in regards to GP recruitment. NHS England and NHS North Kirklees CCG continually review patient survey results and work with local practices to understand any issues and support improvement in patient satisfaction (including access).”

A spokesman from Barking and Dagenham CCG said: “Barking and Dagenham’s population has grown significantly in recent years which has put increased pressure on our GP practices.

“This, alongside the growing demand for GP services, increasing expectations, and the changing needs of patients with more complex and long term conditions means our GP practices are stretched and it can sometimes be difficult to get an appointment.

“There are a number of things Barking and Dagenham CCG are doing to address this. We are continuing to support our GP practices to improve their services, and are planning to increase the number of appointments at practices through the national PMS review.”

The 10 CCGs with the biggest decrease in patients saying “no” when asked if they could get a GP appointment when they last tried were:

CCGPercentage point change from 2013 to 2016

Warwickshire North CCG


South Manchester CCG


Oldham CCG


Southport and Formby CCG


South Gloucestershire CCG


Hammersmith and Fulham CCG


Leeds North CCG


Rushcliffe CCG


Chorley and South Ribble CCG


Slough CCG


Rushcliffe CCG said: “All [Rushcliffe] practices are open 8am to 6.30pm, offering reception services throughout the lunchtime periods Monday to Friday, and no afternoon closures. Ninety-nine per cent of practices were delivering this by 1 April 2015, and 100 per cent by 1 April 2016.”

A spokesman for South Manchester CCG said: “[Access] has been down to the individual practices, who have been working hard to ensure access for their patients, plus the contribution of pharmacists working increasingly within practices.

“[The improvement in access] is also attributable to the extended GP access that enables patients registered with a north, south or central Manchester practice (91 in total) to see a GP outside normal surgery hours. This service is available Monday to Friday between 6pm and 8pm at the 12 community hubs and has also been available seven days a week between 8am and 8pm at three GP-A&E locations.”

Dr James Cavanagh, vice chair of Hammersmith and Fulham CCG, said: “We have implemented seven day access to GP services in Hammersmith and Fulham since September last year offering all patients access to bookable appointments with a GP or practice nurse in the evening or at the weekend.Up to 1 July, over 12,000 additional GP appointments were made available for Hammersmith and Fulham patients.

“Patients are able to book appointments with GPs on the Hammersmith and Fulham performers list at three hubs through their own GP practice, and access to the full patient record is available at each of the hubs with patient consent.”