Do medical outpatients want 'out of hours' clinics?

A questionnaire survey of 300 sequential patients attending cardiac and respiratory clinics to determine patients preferences for out of hours and weekend outpatient clinics. (Out of hours defined as a clinic after 5 pm on Mon – Fri)Two hundred and 64 patients completed the survey of which 165 (62.5%) wanted either an out of hours clinics or a weekend clinic. Sixty four (38.8%) specifically stated that this was because of work commitments but for many others, the reasons given were easy to justify.Current provision for outpatient consultation may not be convenient for many patients with heart and lung disease. A fuller evaluation of the cost and benefits of more flexible clinic hours is now needed.Patient choice is a key part of current U.K. National Health Service (NHS) Strategy [1]. At a time when the population has access to 24 hour banking and to supermarkets which are open 24 hours a day, specialist consultations in U.K. hospitals for non-emergency conditions remain largely confined to the hours of 9-5 pm. In this regard it would appear that the NHS has failed to keep pace with a society which generally demands fast, convenient and 24/7 services.The Department of Health's 10 year plan has echoed these sentiments and specifically states that the NHS has been too slow to change its ways of working to meet modern expectations in this consumer age. While it recognises that the NHS is under funded, money alone can only be a starting point. Cost-effectiveness, it states, is the key to success and this can only be achieved if available resources are used to achieve real benefits for patients. Clearly, the redundancy of most outpatient clinics after 5 pm and during the weekend is not an efficient use of resources, nor is it a modern way of working.Medical practice nowadays strives to be patient-centred [2]. There is good evidence that involving patients in decision-making and listening to the patient voice improves health outcomes and patient satisfaction. Hence, when