An observational study published in BMJ Quality & Safety has suggested that better satisfaction with GP hours, for example, because of extended opening hours, does not affect the number of visits made to A&E in their geographical area. However, making the appointment booking process easier for patients was associated with slightly fewer A&E visits in that area.


Lead author Dr Thomas Cowling from Imperial and colleagues compared patients' experiences of GP surgeries with the number of A&E visits in their areas in England from 2011-2012 to 2013-2014. They examined reports from NHS England's annual GP Patient Survey and included patients registered for 8,124 GP surgeries.

The team measured levels of patient satisfaction using three factors: the ease of making an appointment, opening hours, and overall experience. The researchers then matched these responses with A&E departments in their area to observe any correlation with the number of visits to A&E.

Overall, areas where patients were happier with the ease of making appointments, which could be for example by using online booking systems, saw slightly fewer visits to A&E. However, satisfaction with surgery opening hours and overall patient experience seemed to have no impact on A&E visit rates.

The research supports finding alternative options for easing the burden on A&E departments and might call into doubt the Government's proposals to extend GP surgery hours to ease the burden on A&E departments. The authors measured satisfaction with hours without linking explicitly them to daytime weekday or evening and weekend appointment availability.

The research team hypothesized that although weekend and evening appointments are convenient for healthy, working-aged adults, those who are likely to need medical attention more urgently are older people or those who are chronically ill and not currently working full time.

Senior author Professor Azeem Majeed, who is a practising GP, said the government must find alternative ways to handle current pressures on A&E departments. This could include for example improving access to GP appointments during normal opening hours rather than spending scarce NHS resources on extended opening schemes.

Dr Cowling, also from Imperial's School of Public Health, said: "It makes sense to think that extending GP hours will ease the burden on other NHS services, but the present study suggests this might not be the case with A&E visits."