Following his evidence to the Health Select Committee inquiry into emergency service and emergency care, and comments about the GP contract, Mike Farrar, chief executive of the NHS Confederation, said:

"With specific regards to the contractual arrangements for GP out of hours care, we do not see a correlation between the changes to the 2004 GP contract and the NHS 4-hour waiting standard for A&E departments. In fact for the vast majority of the last decade, A&E waiting time standards have been improving. It is in recent years where the pressures have started to bite, and there have not been any discernable structural changes to out of hours GP contracts during that time.

"It is clearly evident that there are rising pressures on the whole system. We agree there is a need to improve the coordination of out of hours care, and see how it can help take the pressures off A&E.

"We believe real and lasting improvements to out of hours care are possible, but only if we put a greater level of investment in to primary, community and social care."