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.