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Equity and access to extended GP hours hubs

A quantitative study examining access and equity implications of evening and weekend GP hub appointments in England.

Key messages

  • attendance at extended-hours GP hubs declines sharply with increasing distance from the hub
  • geographic proximity is a stronger predictor of uptake than area-level deprivation
  • deprivation alone did not explain differences in use of hub appointments
  • hub-based models may create access barriers for people living further away
  • digital access or outreach support may be needed to avoid inequitable access.

Policy implications

  • neighbourhood health and care models should consider geographic accessibility alongside service availability
  • reliance on centralised hubs risks disadvantaging people who live further away
  • digital access and outreach services may be needed to complement hub-based provision
  • access planning should assess who benefits and who is excluded from extended-hours models.

Gaps

  • no subgroup analysis by ethnicity or income
  • limited insight into longer-term outcomes or patterns of repeat use
  • observational design limits conclusions about causality.

Commentary
This study highlights the importance of place in shaping access to neighbourhood health and care services. While extended GP hours hubs aim to improve access, the findings show that distance is a key determinant of use, with attendance falling sharply the further people live from the hub.

For care equity, the results suggest that extended-hours provision does not automatically improve access for all groups. Although deprivation alone did not predict uptake, geographic convenience appears to play a dominant role, potentially disadvantaging people in less well-connected areas. The findings also raise important questions about hub-based neighbourhood models. Centralising services may improve efficiency, but without complementary digital or outreach approaches, these models risk producing inequities in access.

The study also highlights evidence gaps. Limited subgroup analysis and short-term outcomes mean it remains unclear how extended-hours hubs affect different population groups over time. For neighbourhood health and care, this underlines the need to design access models that account for both geography and inequality, rather than assuming increased availability leads to equitable use.

Neighbourhood health: case studies of good practice

A set of case studies describing early implementation of neighbourhood health models across pilot sites in England.

Key messages

  • pilot sites describe neighbourhood hubs co-locating diagnostics, nursing and mental health services
  • early implementation focuses on integrated, multidisciplinary neighbourhood teams
  • reported benefits include improved continuity of care and service user satisfaction
  • some sites report reductions in A&E attendance following neighbourhood service development
  • delivery models vary across integrated care systems and primary care network areas.

Policy implications

  • co-location of services may support more joined-up and accessible neighbourhood care
  • neighbourhood hubs can act as focal points for multidisciplinary working
  • early learning may inform wider roll-out, but consistent evaluation is needed
  • neighbourhood health models should be adapted to local context rather than replicated wholesale.

Gaps

  • evidence is descriptive, with inconsistent metrics across sites
  • follow-up periods are short, generally under 18 months
  • limited evidence on long-term outcomes or impact on inequalities
  • lack of comparative analysis between different neighbourhood models.

Commentary
These case studies provide early insight into how neighbourhood health and care models are being implemented in practice. By profiling sites that have co-located services and developed multidisciplinary teams, they offer practical examples of neighbourhood models working within the NHS.

Reported improvements in satisfaction, continuity and A&E use suggest potential benefits of neighbourhood approaches. From a care equity perspective, improved continuity and local access may be particularly relevant for people with complex or ongoing needs.

However, the evidence remains early and uneven. Variation in metrics and short follow-up periods limit conclusions about effectiveness or sustainability. It is also unclear how benefits are distributed across different population groups within neighbourhoods.

Overall, the case studies are useful for understanding implementation approaches and early experiences, but they highlight the need for more consistent and longer-term evaluation to assess whether neighbourhood health and care delivers equitable improvements in access, experience and outcomes.