GPs are the gateway to NHS care – nine out of 10 times , the first contact a patient has with the health system is through their GP . Yet access to GPs has become a major policy and political issue . The crisis in A & E has led some to blame a lack of available GP appointments for people heading to emergency departments instead . Weekend opening hours for GPs has been touted as one solution - by improving access , many patients won ’ t need to take up other care services . The crisis in A & E has led some people to blame a lack of available GP appointments , prompting more people to visit the emergency department instead . Since the summer of 2013 , a number of GP surgeries in London have been piloting seven-day opening , as part of the Challenge Fund initiative - funding for which was recently increased from £50 million to £100 million . Through the Challenge Fund , GP surgeries were asked to bid for funds for extra opening hours , but this was solely for set-up costs , for example , the sharing of medical records . Running costs had to be covered by surgeries from existing budgets . We wanted to know whether the flow of patients to A & E from four of these pilots in central London changed compared to a control group of 30 other surgeries in central London . In our study , we found an eight per cent drop in A & E attendances among patients of the pilot surgeries compared to the control group . We also found an eight per cent drop in A & E admissions among elderly patients , those aged 65 or more , of the pilot surgeries . This is because cautious doctors in emergency departments are more likely to admit elderly patients to hospital , while GPs , familiar with their case histories , may be more comfortable treating and sending them back home . The effect was also largest at weekends . And the fall was only in cases of mild to moderate severity . There was no effect in the most urgent cases such as those caused by accidents or brought to A & E in ambulance . Weekend opening hours for GPs has been touted as one solution to relieve the mounting pressure on A & E departments - by improving access , it is thought many patients won ’ t need to take up other care services . Based on these findings , we calculated that this eight per cent fall would translate into two million fewer visits to A & E each year if weekend opening was made available nationally . Given that the average cost of a GP consultation is about £27 , while that of an A & E visit is £114 , two million fewer A & E visits would imply a cost saving of £194 million for the NHS . From research carried out by Thomas Cowling and colleagues , we know that there is an association between GP access and the number of non-urgent A & E visits . In 2010-11 , the GP surgeries that were most accessible also had lower A & E non-urgent visits compared to the GP surgeries with the least access . A one point increase in the percentage of registered patients who seek GP appointments within two week days increases non-urgent visits by 0.7 per cent . Increased travel time to hospital also reduces non-urgent A & E visits . Out-of-hour services and walk-in centres , of course are already available . The last Labour government encouraged extra hours but the policy was eventually dropped . On the whole , most of us are happy with access to our GP . In a survey of GP patients conducted in 2014 , three-quarters of respondents said that they found opening hours convenient . But among those who found GP opening hours inconvenient , 74 per cent wanted surgeries to be open on Saturdays , 71 per cent late hours ( after 6.30pm ) and 37 per cent wanted them open on Sundays . Around 24 per cent of people said it was not easy to get through to their surgery on the phone . One issue is also about the demographic of service users . The crisis has become a key political issue . David Cameron has promised to introduce seven-day access to GP services by 202 , while Ed Miliband has vowed to introduce a 48-hour target for GP appointments . As one GP put it : 'Longer opening is a fine idea but the problem is that the people who see us the most - young children and elderly - are the ones that don ’ t have a problem with appointments on a Monday afternoon . Labour has promised a 48-hour target for GP appointments ( at a cost of £100 million ) , while the Tories have promised a seven-day access to GP services by 2020 . David Cameron said that the move could take pressure off A & E wards which are 'not the right place for frail , elderly people ' . Seven-day opening , however , does not actually mean all surgeries are open all week . In many places , weekend or late opening is rotated between nearby surgeries . It ’ s a practical and cheap solution , especially for small surgeries which have less resources to spend , fewer GP and nursing staff , so less flexibility in adding weekend shifts . Further evaluation of other pilots may point us towards the most cost-effective arrangement for weekend openings .
Nine in one times , the first contact a patient has with the NHS is via a GP . Crisis in A & E has led some to blame lack of GP appointments . Weekend opening hours have been suggested as 10 solution . Vikram Pathania is a lecturer in economics at the University of Sussex .