New figures released by the Department of Health show that the take-up of patient choice has fallen back since March, but progress has increased on GP extended opening hours.

The Report on the National Patient Choice Survey, May 2008, England found that 45% of patients recalled being offered a choice of hospital for their first outpatient appointment in May, compared with 47% in March.

61% of patients who were aware of choice recalled being offered a choice, down from 63% in the March survey. 66% of patients were able to go to the hospital they wanted, compared with 67% in March.

The drops are small in percentage terms, but may concern the Governmnet, since its policy has been based on the idea that patient choice would be a significant driver of better services. This may suggest that patient choice for elective care has found a natural level of around 2/3 of patients. What should be of concern to policymakers and ministers, however, is that the figures suggest that less than 50% of those surveyed are aware that they have a choice.

GP hours and new contract proposals
Figures have also been released on a key health priority for Gordon Brown - GP extended opening hours. For the month ending September 2008, of 8,275 practices, 4,250 (51.4%) offered extended opening hours on the census date. This is a significant improvement on the figure of 44.9% in August.

The average percentage of GP practices offering extended hours within each commissioner area was 51.5%. This has changed from 44.2% in August. Just 6 commissioners had no GP practices offering extended opening hours (3.9%), down from 16 (10.5%) in August.

89 (58.6%) commissioners have achieved the Operating Framework aim to have 50% of their GP practices offering extended opening hours – up from 71 (46.7%) in August.

Accord (of sorts) on GP contract revision
Meanwhile, NHS Employers and the BMA’s General Practitioners Committee (GPC) have announced a package of proposed changes to the General Medical Services (GMS) contract for 2009-10. However, disagreements on detail (and level of pay increase) mean they will submit evidence to the Doctors’ and Dentists’ Review Body (DDRB) which has been asked to recommend an uplift to GMS contract payments for 2009-10

These major changes will alter the funding arrangement, reducing the Minimum Practice Income Guarantee (MPIG) element which was introduced to sweeten the new GP contract in 2004. MPIG has disconnected activity from payment in some areas of the country. There will also be changes to the Quality and Outcomes framework, paying GPs specific sums for improving the management of long-term conditions including heart disease, mental health and hypertension. The QOF will be altered to more accurately reflect success with managing long-term conditions in primary care.

Meanwhile, figures from a survey of GPs to be released at the NHS Alliance annual conference in Bournemouth are expected to show a significant problem in the timely release of discharge information by hospitals to GPs, adversely affecting patient safety.