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'Routine appointments on Sunday were not popular’

Dr Sara Khan tells Pulse that routine GP appointments on Sundays were not popular during her practice’s seven-day access pilot

In our area in Hertfordshire, practices have been offering 8am-8pm appointments, seven days a week, on a rotating ‘hub’ basis.

For example, if a GP surgery was normally open until 6.30pm in the week and one of their GPs was on rota that day, they would stay open until 8pm.

Shifts were filled easily at the start when the pay rates were high, but not when pay was reduced.

Routine GP appointments on Sundays were not popular, so have been drastically reduced. Sundays are quite popular for phlebotomy, though.

Our Challenge Fund pilot has not led to a reduction in A&E activity and it has, some GPs tell me, hampered continuity of care. Some patients are seeking a second opinion from their regular GP after visiting a hub practice.

GPs have also struggled with IT during the pilot as they were not able to enter information directly onto clinical systems of other practices. So when GPs need to refer patients not on their own list, duplication occurs in the system.

Although patient reviews have been positive, with 98% saying they would recommend the hub service, increasing patient expectations via pilots like this is not helpful in a cash-strapped NHS.

Our local pilot evaluation showed more than half of patients would have just waited for a routine appointment if they had not had this service, indicating that they went for convenience only.

I see continuity as an integral part of routine general practice and for urgent problems there is an out-of-hours GP service, which is excellent locally. It is known that disruption in continuity affects cancer diagnoses, something in which the NHS lags behind Europe.

Dr Sara Khan is vice-chair of Hertfordshire LMC and edits the Medical Women’s Federation’s magazine, Medical Woman

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Readers' comments (6)

  • ''Shifts were filled easily at the start when the pay rates were high, but not when pay was reduced.''

    Does this mean when doctors were paid well the patients were happy to see the doctor, and when the doctors pay was reduce the patients were unhappy and decided not to see the doctor. Sounds funny

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  • Vinci Ho

    Translating the whole thing into questions to our patients:
    (1)Would you prefer to be able to see a GP 7 days a week but with no choice of which GP?
    (2)Would you prefer your GP of choice be available on Saturday and Sunday but will not be so during some weekdays ?

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  • Publish the benefits appraisal as widely as possible!!!

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  • I don't think Hertfordshire is representative of rest of the country.Please stop generalising

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  • I don't see any "generalising" (anon @9.53) and would suggest in any event that Hertfordshire is more representative of the country than the London-centric "solutions" that are being forced upon the rest of us.

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  • Hertfordshire is more representative than Manchester.

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