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GPs buried under trusts' workload dump

Consultation key to opening hours

Lesley Mayo's article on extending GP opening hours (Finance, 10 October) provides a good overview of the range of issues involved when redesigning services in primary care. However, the article omitted patient consultation as a key element of that process.

Section 11 of the Health and Social Care Act 2004 places a duty on NHS trusts, PCTs and strategic health authorities to make arrangements to involve and consult patients and the public on the design and delivery of services.

A good example of effective patient involvement in the secondary setting is Breakthrough Breast Cancer's service pledge for breast cancer, where healthcare professionals in breast units work with patients to identify areas for improvement.

While changes to working practices need to include staff consultation, GP practices would benefit greatly by ensuring patients are included in any consultation on changes to the services delivered at the surgery.

The results could prevent practices opening at times or delivering services that patients will not use, and ensuring money is spent on services both staff and patients agree are most important.

Jeremy Hughes, chief executive, Breakthrough Breast Cancer, London WC1

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