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Use all the methods to make it cost effective

There are a number of ways in which a practice can run extended hours as cost-effectively as possible, says Bob Senior

There are a number of ways in which a practice can run extended hours as cost-effectively as possible, says Bob Senior

Most practices offering extended hours are doing so for one of two reasons:

• to avoid losing the income that would be removed from the practice if they did not offer extended hours

• to avoid losing patients to other local practices that do offer extended hours appointments, and perhaps attract patients from those that don't.

Most practices are not expecting to earn additional income from extended hours, so they need to provide them for as little additional cost as possible.

Most PCTs require the GP appointments offered under extended hours to be provided in addition to existing appointments.

In those circumstances there is no alternative to either:

• partners working longer hours, or

• paying salaried doctors or locums to work extra hours.

The attention therefore needs to turn to minimising the ancillary costs as much as possible. This could include:

• operating a locked-door policy with only one receptionist on duty

• changing staff rotas (with their agreement) so extra staff hours are avoided

• offering staff time off in lieu rather than overtime.

There are restrictions on how the hours are to be provided, typically limiting the number of doctors that are able to be involved at the same time.

But all practices should consider maximising the use of the building if it is going to be open anyway.

This could easily apply to Saturday morning surgeries where GPs not directly involved in extended hours could deal with private medicals rather than trying to fit them into the working weekday.

Practices should also consider running nurse-led clinics in extended hours, making them more convenient to patients who cannot easily take time off work.

Flu clinics are an obvious choice at this time of year where there is the opportunity to earn additional income.

Encouraging a greater uptake by offering clinics to patients outside normal hours could generate increased profits.

Bob Senior is vice-chair of the Association of Independent Specialist Medical Accountants and director of medical services at Tenon, the UK's third largest medical accountant

Bob Senior - use all options at your disposal to make extended hours pay Bob Senior - use all options at your disposal to make extended hours pay

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