Satisfaction, demand, and opening hours in primary care: an observational study

Abstract

Background: The ease with which patients can make primary care appointments in the UK has been subject to a pay for performance scheme since 2004. A separate scheme, extended hours - the provision of extra appointments outside normal office hours -was introduced in 2008.

Aim: To examine how the provision of additional morning, evening, and weekend appointments influences patient satisfaction with opening hours.

Design and setting: An observational study in primary care.

Method: The study collated information on extended hours for all practices in 13 English primary care trusts (n = 639). After examining the descriptive statistics the study ran a series of clustered logistic regression models, comparing additional periods of service provision to practice characteristics and to patient satisfaction with access and opening hours in the GP Patient Surveys.

Results: Practices offering Saturday appointments saw a relative decline in demand for additional hours. Practices offering other time periods did not see this. Satisfaction with opening hours improved slightly for practices offering extra appointments, but was not linked to anytime period. The terms and conditions of the extended hours scheme are loosely implemented and this may have limited the apparent effectiveness of the scheme.

Conclusion: Demand for additional opening in primary care is only influenced by Saturday appointments. Satisfaction with opening hours responds to increased capacity, but is not linked to a specific time period.