Open all hours

Sir Bruce Keogh’s plans for seven day working hospitals and talk of more patient friendly hours for GPs has prompted some to ask whether it will be a requirement under our next contract to contain similar provisions. Will our motto have to be ‘Open All Hours’ (apologies to the BBC programme of that name)?

Well for a start there is no need for the powers-that-be to wait for a new contract before moving in that direction. Every contract now has practice opening hours written into it. It is open to NHS England in its commissioning role to offer new contracts for a practice to be open from, say, 8am to 10pm six days a week with six hours on Sundays like the supermarkets.

A bit difficult for a single-handed dentist to achieve but I am sure corporates would be falling over each other to bid for them. The question is not whether NHS England wants this but whether there is sufficient demand from the public to make such practices viable.

For most of the first 50 years of the NHS (it ‘celebrated’ its 65th birthday this year for those whose history is shaky), the aim of most practices was to build up a loyal group of patients. They would come regularly, even sometimes returning after they had left the district. They didn’t ‘need a lot done’; they brought in their spouses, their children and grandchildren.

There were a few who came needing a lot of work, often after years of neglect, but the regular patients formed the backbone of the practice. They still do and they probably stuck with the same banks, same insurance companies and, of course, same GP.

Nowadays they are being displaced by the so-called Generation X (born in the 60s and 70s) and Generation Y (born in the 80s and 90s). Marketing articles will tell you that there are differences between these generations, but one of their defining characteristics is their use of the internet.

They look first to their laptop when buying to find the best brands and best bargains. They will switch banks and energy companies. They would never think of renewing their care or household insurance without first looking at a comparison website.

For their dentistry they might well look for extended opening hours, rather than the reputation of an individual dentist. At present most, but by no means all, practices stick to ‘conventional’ opening hours. Most rely on the inbuilt loyalty of their patients to maintain their practice.

Although NHS England currently stresses the importance of regular contact with the same dentist, they may well have to encourage those patients with no idea of ‘brand loyalty’, if they want to increase numbers seen. Perhaps dentists need to ask themselves how they would fare on a ‘Compare Practices’ website. There’s a thought of 2014.

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