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A flexible approach can allow small practices to offer extended hours

I am writing to give my own experience of running extended hours at a small practice ('Extended hours stripping cash from poor practices').

We have very good access during the normal working week with same-day appointments for any reason and the option to book months ahead. Despite this we were aware a small number of our patients (the ones with full-time jobs) could not access us easily during the day.

The extended hours scheme meant there was money attached to something we were thinking of doing in any case. The removal of money from elsewhere in our contract to pay for extended hours also meant we couldn't afford not to do it. We decided we would only do extended hours if:

  • it met an unmet patient need (which it did)
  • sessions were run by existing staff, as we value continuity
  • the extra hours were at a time that patients wanted and that we could provide, given the constraints of provision with existing staff.

We put all this into our application to the PCT and now offer extended hours on Monday evenings until 8pm. Patients are booked in for 15-minute slots with me or a practice nurse who provides a well-woman service, travel vaccinations and advice on losing weight and smoking cessation.

Being a small practice did restrict what we were able to offer. If the PCT had insisted on a Saturday morning surgery it would have been difficult to provide, would have had no nurse and would have provided a poorer service. But I enjoy the longer appointments and patients think it is marvellous.

From Dr Patrick Craig-McFeely, Salisbury, Wiltshire

extended hours

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