Extended opening hours in primary care: helpful for patients and—or—a distraction for health professionals?

Baker, Richard; Walker, Nicola

doi:10.1136/bmjqs-2016-005415

Cited by 4 publications

(3 citation statements)

References 7 publications

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“… 12 The evidence for extended opening hours being clinically worthwhile and financially viable is currently weak, with pilots of extended hours failing to attract patients to their service, especially at weekends. 13 This supports the view that patient satisfaction with new ways of working can vary depending on patients’ needs for essential care outside of the traditional working week (typically Monday to Friday, 9 am to 5 pm). 14 In the evaluation of the first wave Enhanced Primary Care programme (EPCP), the GP perspective was limited to a survey of collective staff satisfaction 15 and GPs’ perspectives in relation to the national policy implementation of the EPCP have not been explored.…”

Section: Introductionsupporting

confidence: 62%

Factors affecting decisions to extend access to primary care: results of a qualitative evaluation of general practitioners’ views

et al. 2018

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ObjectivesTo report general practitioners’ (GPs’) views and experiences of an Enhanced Primary Care programme (EPCP) funded as part of the Prime Minister’s Challenge Fund (second wave) for England which aimed to extend patient access to primary care.SettingPrimary care in Sheffield, England.ParticipantsSemi-structured interviews with a purposive sample of GPs working in 24 practices across the city.ResultsFour core themes were derived: GPs’ receptivity to the aims of the EPCP, their capacity to support integrated care teams, their capacity to manage urgent care and the value of some new community-based schemes to enhance locality-based primary care. GPs were aware of the policy initiatives associated with out-of-hours access that aimed to reduce emergency department and hospital admissions. Due to limited capacity to respond to the programme, they selected elements that directly related to local patient demand and did not increase their own workload.ConclusionsThe variation in practice engagement and capacity to manage changes in primary care services warrants a subtle and specialist approach to programme planning. The study makes the case for enhanced planning and organisational development with GPs as stakeholders within individual practices and groups. This would ensure that policy implementation is effective and sustained at local level. A failure to localise implementation may be associated with increased workloading in primary care without the sustained benefits to patients and the public. To enable GPs to become involved in systems transformation, further research is needed to identify the best methods to engage GPs in programme planning and evaluation.

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Section: Introductionsupporting

confidence: 62%

Factors affecting decisions to extend access to primary care: results of a qualitative evaluation of general practitioners’ views

et al. 2018

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“…Although healthcare professionals were able to give patients self-management and lifestyle guidance, patients’ actions are affected by a range of variables, such as their work demands, beliefs and environment. Baker and Walker 42 indicated that extended opening hours at primary healthcare facilities are beneficial for patients and not a distraction for health professionals as they usually perceive it as such. As indicated by Sigh et al, 43 83% of those affected by the COVID-19 lockdowns in India reported difficulties in accessing healthcare; 17% experienced difficulty in accessing medications; 59% reported a loss of income, 38% experienced job losses and 28% reduced their intake of fruits and vegetables.…”

Section: Discussionmentioning

confidence: 99%

Experiences of patients with chronic diseases during the COVID-19 pandemic in the North West province, South Africa

Mboweni¹,

Risenga²

2023

S Afr Fam Pract

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Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic.Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients’ experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files.Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations.Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future.Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs.

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“…Governments in Canada and the United Kingdom have recently pledged improved access to primary care after hours, 34,35 and our study highlights the importance of prospectively evaluating such reforms. Improving after-hours access to primary care may hold value for patients; however, benefits must be weighed against potential opportunity costs, including an increase in physician workload, 36 a decrease in daytime access for patients given a fixed primary care workforce already stretched by existing demand, or both.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Use and Enrollment in a Medical Home Providing After-Hours Care

et al. 2018

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Extended opening hours in primary care: helpful for patients and—or—a distraction for health professionals?

Cited by 4 publications

References 7 publications

Factors affecting decisions to extend access to primary care: results of a qualitative evaluation of general practitioners’ views

Factors affecting decisions to extend access to primary care: results of a qualitative evaluation of general practitioners’ views

Experiences of patients with chronic diseases during the COVID-19 pandemic in the North West province, South Africa

Emergency Department Use and Enrollment in a Medical Home Providing After-Hours Care

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