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At the heart of general practice since 1960

Extended hours? You must be joking...

The receptionist was outraged. ‘Choose a practice? You can’t choose a practice!’ she said. ‘You have to write to the local authority and they will allocate you one.’

By Steve Nowottny

The receptionist was outraged. ‘Choose a practice? You can't choose a practice!' she said. ‘You have to write to the local authority and they will allocate you one.'

If you're lucky, the tone implied. Clearly the Government's flagship choice agenda has some way to go in parts of rural North Staffordshire.

Last week, I called round 200 practices across the country to research our story this week on extended opening hours. Analysis of the data shows clear national trends in terms of who is opening evening and weekends – large practices over small and, often, rich areas over poor.

But above and beyond the statistics we gleaned from the exercise, calling round so many practices in quick succession gave me a real insight into how patients are experiencing extended hours on the frontline.

My interaction with the practices was brief. I didn't want to waste their time, and I had a long list to get through. So all I asked was simply whether they offered appointments in the early morning or late evening, or at weekends. And if cross-questioned why I wanted to know – and receptionists as a breed are not averse to a bit of cross-questioning – I said I was interested because I was considering choosing a different practice.

Which led to the outburst from Outraged of North Staffordshire.

But calling round so many practices was an education. Some were impossible to get through to, even on three or four attempts – either it was engaged, closed or I got lost in a Byzantine phone system. Others were perhaps too accessible – on at least two occasions, it was the GP himself who answered the reception phone.

When I asked about the availability of extended hours, some receptionists were dismissive, even laughing. ‘We don't want to work weekends,' they said. Others treated me as a mythical beast – they had heard about the new species of patient so desperate for an evening appointment they would consider switching practice, but I was the first they had ever encountered.

Very few knew the times of evening or Saturday surgeries off the top of their head. Clearly it's not a frequent enquiry.

And if they did offer extended hours, the mix of appointments on offer was striking too. Most had set hours, but insisted on patients booking ahead - some were booked up several weeks in advance. Others said that appointments were booked from the beginning only, so that the GP could go home when there were no more patients. Every surgery, it seemed, was dealing with extended hours in its own unique way.

And as for the North Staffordshire practice's own unique way of dealing with it? Well, I considered for a minute quoting the NHS Constitution, or informing the receptionist that actually Ben Bradshaw had made it quite clear that patients were entitled to register with any practice they chose.

But somehow, I don't think she'd have believed me.

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