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Small practices must look at bigger picture

Singlehanders and small practices should take a long-term view and not be daunted by costs and workload, advises Dr Michael Taylor

Singlehanders and small practices should take a long-term view and not be daunted by costs and workload, advises Dr Michael Taylor

I felt pressured over extended hours because as sole principal in a 1.6-doctor practice I presumed I had total awareness of my patients' needs and felt they were already being met.

But when a similar-sized practice down the road opened a popular evening surgery, I had to think again.

I started opening for one-and-a-half hours on Thursday evenings two months ago.

My practice calculated the extended hours deficit for a GP and two receptionists would be £1,300 a year, but there were compelling reasons why we couldn't afford not to open and these outweighed the financial deficit.

When looking at extended hours, singlehanded GPs and small practices should consider the following.

• Remember patients like the service.

• You need to compete to maintain list size and income.

In my area competition is fierce. Soon there will be two Darzi clinics opening 8am-8pm seven days a week within four miles of my practice.

Next year a Darzi practice will launch within half a mile of the practice.

Each of these is likely to spend about £25,000 on marketing.

• Extended hours can be cost-effective. Our service has let us scrap plans for an extra daytime GP session to serve our expanding list.

The session cost of £10,000 a year dwarfs the £1,300 extended hours deficit.

Some tips to remember when considering extended hours:

• See it as a way to make the practice more attractive and retain income.

We had long thought it would be a good idea to use our premises in the evening - so you could say we are receiving a subsidy from the PCT to do what we were already considering.

• Consider provision of alternative services as the PCT is paying for the reception staff.

• Keep staff happy - we offer ours time-and-a-half.

• Don't burn yourself out - use a locum.

• Work with nearby practices to share back-room functions and reduce costs.

If you introduce extended hours with care, bide your time and grab those chances for further income generation, you could create a practice ready for the future and all the threats and opportunities it will bring.

Dr Michael Taylor is national chair of the Family Doctor Association (see www.family-doctor.org.uk). Since writing this article he has temporarily suspended his extended hours service at his surgery in Heywood, Lancashire, in support of other practices in his area that have rejected the PCT financial package

Dr Michael Taylor - small practices shouldn't be daunted by costs and workload Dr Michael Taylor - small practices shouldn't be daunted by costs and workload

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