Extended hours: best thing for general practice?

Posted on July 29, 2009. Filed under: News stories | Tags: , |

Healthcare Republic | By Neil Durham | Editors’ Blog | 29 July 2009

I had a GP appointment at 7.25am yesterday. It’s the first time I’ve used extended hours and what an interesting experience it was.

I arrived at 7.15am half expecting to be kicking my heels in the car park but was buzzed through a locked door via a receptionist at the end of an intercom. Mr 7.35am arrived five minutes later. 

At 7.25am sharp the consultation began. Whilst having my BP taken, there was a chance to talk extended hours and my GP loves them: ‘I drive into work at 7.10am and I see all the commuters on the roads or going to the station, so I know people work hard.’ He thought the practice should extend them further but his partners, who have young families, were less keen.

The downside is that his PCT isn’t keen to lose any appointments during the day, so there are workload issues. (Trust me, I’ve done weird shifts and know they mess with your mind. I once went to bed with a mobile in caseShakespeare In Love director John Madden called in the early hours for a post-Oscar victory chat. Clue: he did.)

For me as a patient, extended hours are fantastically convenient. But I guess working them is another matter. Before their introduction I visited the walk-in centre near work because my practice wasn’t open before I left for work or when I got home. And though the concept of immediate walk-in access appeals, the reality of waiting indefinitely to see a random nurse who knows nothing about you is less enticing.

Of course the way extended hours were introduced by the government was too bullying. But there’s so much to commend my practice this is easy to forget: I get on with my GP, he knows my history and I like to think we’ve established a rapport.

My grandparents are still alive and it seems to me that the more we age the more vital continuity of care becomes.

The key to this – and, probably, the future of general practice – must be protecting the registered list. Surely no government would dare threaten this as popular practices become even more accessible to their patients?

Are extended hours an urban solution to an urban problem? I live in south-east London, a 60-minute commute from where I work in south-west London. I’m sure there are less urban locations where there’s just no demand for extended hours. I can’t think of anything more annoying than kicking my heels at work with nothing to do early in the morning or late in the day because the PMinsists needlessly I do so.

We’re keen to know what you think and today launch an extended hours survey about your experience and views.

Are extended hours really the best thing that’s happened to general practice? Or am I, and my GP, alone on that one?


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