Opening doctors' surgeries at weekends won't solve A&E crisis| Zara Aziz

Opening doctors' surgeries at weekends won't solve A&E crisis| Zara Aziz Extended GP hours will not take the pressure off A&E units when existing out-of-hours care has unable to.

Department of Health plans for a pilot project in which GP practices will open from 8am till 8pm seven days a week are being debated. There is an argument for better extended-hours access for those unable to get to surgeries during the day. Yet current staffing levels mean that routine care on other days is likely to be cut to meet the extra demand, which could be problematic for elderly or chronically ill patients.

Extended GP hours cannot take the pressure off A&E units when existing out-of-hours care has not been able to do so. At our practice, we continually audit our A&E attendances, as do other practices in the area. In many cases, it is older people with comorbidities who are taken by ambulance and wait for hours on trolleys in emergency departments. Often these patients have little social support or limited care provision, and a minor illness such as a urinary tract infection can tip the balance.

But there is little infrastructure to support anything other than emergency out-of-hours medical intervention. District nursing and rehabilitation teams are at breaking point and services such as x-rays, sample collections and patient transport are not available at weekends or in the evenings. So hospital admission is often the only safe place in the middle of the night, even though it does not get to the root of the problem.

Is there really a need to replace existing out-of-hours services, given that we cannot provide a 24/7 service and would have to look at forming local configurations? The nature of the service would probably not change; it would just mean that the government would applaud itself for handing out-of-hours care back to GPs. I see no evidence of policymakers understanding either GPs' workloads nor patients' problems. I see more patients with anxiety, stress and depression than ever. Economic hardship has had a significant impact on the health of our patients and GP consultation rates are soaring.

We are often the first port of call, but how can we manage demand without increasing GP numbers? It is the paperwork (hospital letters, blood results, medical reports, referrals and emails) that keeps us working from 8am till 8pm in any case. The public is never told about the extent to which GPs are sinking under red tape. They are not told that GP appointments are hard to get because GPs are retiring and training budgets are restricted; and that there is a serious recruitment crisis in deprived parts of the country. GPs generally offer 10-minute appointments but usually spend longer than that on consultations. Most GPs will have 30 to 40 patients a day, and it would be unsafe to extend the day further.

Our nursing and allied staff often see extra patients, work longer than their contracted hours, deliver equipment and samples, and sometimes even transport patients. There are no breaks, and on a good day you get to eat between seeing patients, or go home in time to say goodnight to your children.

Politicians fail to recognise the vast amount of goodwill displayed by so much of our workforce, which keeps the NHS wheels turning. It is this lack of understanding that is disillusioning many GPs. Unless there is a drastic increase in GP numbers, practices like mine will simply be unable to offer weekend appointments.

I often wish that David Cameron or Jeremy Hunt could sit in my consulting room. Perhaps then they would understand. As it stands, their policies are at best misguided, at worst political stunts. The Guardian