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Independents' Day

Practices in extended opening pilot see list sizes rise

By Steve Nowottny

Practices that have started offering extended hours have seen their list sizes increase as patients have chosen them in favour of neighbouring surgeries.

A pilot of extended access in Waltham Forest found longer opening hours had proved 'very popular' with patients, PCT bosses said.

Commissioning extended hours appeared to generate fierce competition between practices.

Practices participating in the extended hours pilot, launched in 2005, had seen 'a larger than average increase in the growth of their list size' as part of a 'comprehensive and sustained quality improvement drive', according to a PCT spokesperson.

The confederation's report, Access All Areas, concluded the pilot has shown 'patient choice can be a powerful lever to deliver improvements in access.'

Commssioning extended hours would see patients piling pressure onto practices that did not do so by 'voting with their feet', the report added.

Dr Dinesh Kapoor, a GP in Waltham Forest who was one of the first to participate in the 8am until 8pm extended hours pilot, and is now considering taking up the LES, said extended opening had led to an increase in patients registering and 'healthy competition'.

Dr Kapoor said his practice normally recruited about 70 patients a month and lost about 50, but that growth had been substantially faster since offering extended opening. But he warned there was a 'downside' to offering extended hours, with a high rate of DNAs and many non-commuters taking evening appointments.

News of the pilot results came a week after Pulse revealed practices were taking up extended opening incentives and openly marketing their hours to tempt patients away from neighbouring surgeries.

One practice in Derbyshire advertised its Tuesday evening surgery on its website, saying: 'Appointments can also be used by patients from other practices in the town, should they wish to change practice.'

But Dr David Shubhaker, secretary of Redbridge and Waltham Forest LMC, disputed the conclusions that extended opening had generated competition and encouraged patients to move, saying patinet lists in the area were already 'bulging'.

‘The centres who did the pilot stopped the pilot, as soon as the money ran out,' he said.

'I think it was mainly incentive-driven, rather than patients demanding it.'

Extended hours stoke competition

- Waltham Forest pilot finds practices offering extended hours saw a ‘larger than average increase' in list sizes

- NHS Confederation report warns patients not offered extended hours will begin ‘voting with their feet'

- GPs offering extended hours begin marketing evening surgeries to patients of neighbouring practices

Dr Dinesh Kapoor: growth in list substantially faster since offering extended opening. Dr Dinesh Kapoor

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