Use of Floating Catchment Area models to investigate trends in ‘extended hours’ GP provision

In Wales, as elsewhere there are concerns surrounding the difficulties in obtaining timely appointments to primary health care services. Timely access to primary health care services has been identified in a number of studies as a contributory factor influencing patient decisions to self-refer to secondary care. Such studies have drawn attention to the need for more research on potential inequalities in primary care provision. In this paper we highlight the use of Geographic Information System (GIS)-based tools that permit a consideration of population-to-provider ratios over space to examine variations in geographical accessibility to GP surgeries that provided extended hours of opening for patient appointments. Access to GP appointments outside of so-called ‘core’ hours shows considerable spatial variation within Wales and our findings highlight spatial mismatches of ‘extended’ hour’s provision available at GP surgeries. GIS tools should be used by planners to target patients whose needs are not currently being met by existing GP operating hours or for employed people who require appointments outside their working hours. These tools should inform future policy concerning the collaborative delivery of services and the exact choice of surgeries or hubs selected for extended access provision.