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BMA warning over extended opening hours

10 September 2007

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Extending opening hours could penalise the most needy patients, the BMA claims.

Responding to the Health Secretary’s statement that he wants GPs to provide extended opening hours, Dr Laurence Buckman, Chairman of the BMA’s General Practitioners Committee, says:

“If practices were to operate routine surgeries over extended hours then other NHS services would need to be open too. Laboratories would need to be open to make sure patient samples can be dealt with quickly without having to ask the patient to return for another appointment, for example to give a blood sample.

“Hospital out-patients and X-Ray tests and other services which work with primary care would have to be available too. GPs do not operate on their own and they would also need their surgeries staffed and supported.

“All this will cost a lot of money, never mind the fact that there may not be enough GPs and other NHS staff to actually provide such a service. The shortage of GPs continues to be a serious issue and addressing that was one of the reasons the new contract was brought in in the first place.”

“This government introduced the new contract and now seems to be trying to destroy its agreement only three years later. Young doctors are unlikely to want to become GPs if so little trust can be placed in the word of the government.

“If the government isn’t willing to consider the workforce issues and the cost implications sensibly then surgeries will have to close at other times of the day. This will take appointments away from the patients who need and use us the most – the elderly, mothers with young children and those with chronic conditions.”

The government’s own GP Patient Survey published in July shows the vast majority (84%) of patients are happy with current opening hours and only four in every hundred patients want extended opening hours in the evening.

The survey, which cost £11 million, also showed that only seven out of every hundred patients (from more than 2 million in the survey) wanted Saturday surgeries.

Related story: GP out of hours care steadily declining

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“I definitely support the views of BMA. Most GPs already work 10–12 hours a day. My main concern is that are we going to be dealing with prebooked appointments or are we going to dealing with home visits for people who ring up five minutes before the surgery for extended hours closes? Health Minister Ben Bradshaw is quoted in some newspapers as saying that the proposal is to extend hours and not limit them (core hours during the day). So we will do three surgeries in a day. A recipe for burnout most definitely” – Dr Nanda, Middlesbrough

“As with everything in life, nothing is impossible if you put enough money and resources behind it. Where are the funds going to come from to pay for staff shifts, extra doctors and nurses and amenities if PCTs are already paying for the OOH services that exist at the moment and GP practices are not seeing any uplift in baseline or growth money?” – Steve Mowatt, Bristol

“No problem with working additional hours if it is funded and we can afford the additional staffing costs. We have only two doctors in this very rural practice and working a one-in-two rota is very different from a one-in-ten in a bigger practice. Who will guarantee that those people working during the week will be able to book their appointment later or on Saturdays? Do we interrogate each person as to whether they can come at another time? We are about to go for the access system that allows patients to book appointments on line so who knows what we could do to vet patients then? This is a situation created by those who negotiated the GP contract. They grossly underestimated the costs involved in providing an out-of-hours service previously done by GPs as part of their workload and a very long working week. The government is now trying to cut its losses and is continually spinning against GPs for a contract that they agreed. They are creating a situation where they would like patients to have what they want when they want it but we all know that the NHS is a cash limited service and so if you add something here you squeeze out something there” – Shirley Moth, Eastbourne

“I worked in retail for over 20 years before coming into the ealthcare sector. This reminds me very much of the onset of Sunday trading, where the workforce was very much against (for purely personal reasons) and the stores’ executive managers were in favour (on grounds of increased sales and profits). With regard to extending surgery hours, this will not provide for any more appointments being available, simply at different times. What it will do is increase costs to practices (heat, light, staffing) which will have to be met by the DoH, and will not ensure that those ‘unable’ to attend during normal hours are the only ones who attend OOH – inevitably the ‘usual suspects’ will line up for this new opportunity! However, given this Government’s attitude towards General Practice, if we do not find a solution, one will be imposed upon us sooner rather than later. For this reason alone, I am in favour of extending hours – on our term” –  Roy Partington, Business Manager, Wellington House Surgery

“Working for a singlehanded GP who until 3 years ago opened every Saturday morning I don’t agree that surgeries should open longer and unsociable hours, just to suit the needs of the minority of patients who at the best of times feel that because they don’t attend the surgery very often are entitled to come when they want and that they earn some kind of loyalty points. My staff and I worked Saturday mornings on a rota, and the only patients that came were for minor surgery or to collect prescriptions that could have waited until Monday. Most Saturdays we waited for patients to turn up. What a waste to all concerned and the expense of opening the surgery. We would have to employ staff just to cover the extended hours as nobody wants to work the hours that are possibly being suggested” – Susan Dardis, Practice Manager, Manchester