Extended hours consults limited

Small practices in Scotland will only have to deliver extended hours clinics once a month.

Under the new extended hours directed enhanced service (DES), practices with list sizes of less than 1,000 will only have to open for an extra 30 minutes once a month.

Practices with lists of between 1,000 and 3,000 patients will have to provide the services once a fortnight.

Scottish practices will also be allowed to shift a daytime surgery to an extended hours surgery unlike in England, where core provision must not change.

Guidance on the extended hours DES for primary care organisations has been released in England and Scotland. Welsh GPs are expected to receive their own guidance soon.

English practices must open for 30 minutes a week for every 1,000 registered patients in blocks of 90 minutes.

GPC deputy chairman Dr Richard Vautrey believes the English guidance offers PCTs the freedom to develop local enhanced services (LESs). 'I think it is more permissive than PCTs were expecting. It doesn't railroad them into using a DES.

'LESs are the way forward. With a LES you can provide clinics that effectively meet the needs of your patients.'

Under the English extended hours DES, the 90-minute block can be reduced into shorter clinics where practices have less than 3,000 patients or are offering appointments before 8am.

In all practices in Scotland and for large practices in England, two GPs working simultaneously for an hour would count as two hours. Both DESs will make quarterly payments of £2.95 per patient to practices that meet the requirements.

England guidance

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