Doctors to Extend Afternoon Hours in Health Centers for More Appointments

The Ministry of Health is preparing significant changes in Primary Care. Health centers are usually the entry point for citizens to healthcare, which is where the greatest service congestion can occur.

In this regard, the Health Ministry has proposed a reorganization of doctors' working hours to increase the availability of scheduled appointments. This change means that by 2025, primary care doctors will extend their regular hours from Monday to Friday to increase the availability of scheduled appointments. The administration aims to achieve this by excluding Saturdays from the regular hours of Primary Care teams, limiting those days to continuous care shifts, "with the corresponding additional remuneration," the ministry adds in a press release.

The Health Minister, Marciano Gómez, explained that Primary Care healthcare staff work an average of 8 Saturdays a year to complete the annual regular work hours, so those hours currently worked on Saturdays would be compensated in afternoon shifts from Monday to Friday, "thus increasing the availability of appointments on those days." Additionally, Saturdays would be paid as shifts from 8 a.m. and not from 3 p.m. as before.

"The purpose of this proposal, which will be presented at the sectoral table, is to adjust to reality the service provided by primary professionals on Saturdays, as emergencies are attended to and not scheduled consultations, so we understand that these days should be considered as shifts for all purposes, and not as part of the regular work hours," the minister specified.

He also indicated that it would be a reorganization of work hours that does not imply a reduction in the current annual work hours, whose reduction for all healthcare center staff will be implemented under the terms provided in the Agreement of the General Negotiation Table of civil servant, statutory, and labor personnel of the Generalitat.

Marciano Gómez held a meeting with the Primary Care directors of the health departments in the Valencian Community, as well as with the managers of the Interdepartmental Health Groups, where the implementation of "a comprehensive plan for the improvement of Primary Care, which includes measures such as the aforementioned reorganization of regular work hours, among others, and includes the drafting of the decree project for the structure, organization, and functioning of primary and community care of the Valencian Health System."

As part of this comprehensive plan, the Health Minister explained that "work is also underway on a single agenda model for each Primary Care professional, with the aim of standardizing, unifying, and systematizing processes that allow for the implementation of shared demand management and optimizing appointment management with the support of artificial intelligence (AI)."

From the rounds of contacts with professional associations, scientific societies, and representatives of the involved groups, the Health Ministry assures that the configuration of the agendas "is not reflected in the recorded average delay times to be attended to, as many times despite not having available appointments in the agenda within a certain period, patients who requested to be seen earlier were attended to in a much shorter time, without that circumstance being reflected."

They add that this circumstance is compounded by the fact that patients report that 52% of calls in some health centers are not answered, and the data shows that "the average delay times that result from the current agenda structures are higher and do not correspond to those of the real resolution of consultations," the minister specified.

Gómez stated that the new Primary and Community Care model that the Health Ministry plans to implement proposes a new hierarchical structure for healthcare staff that is comparable to that of Hospital Care. To this end, it is planned to create the service chiefs of Primary and Community Care and the section chiefs of Primary and Community Care, with the aim of enhancing the prestige of Primary Care and its professionals.

As Marciano Gómez indicated, "the role of these professionals will be key to assessing the care demand and establishing the necessary mechanisms to avoid delays in the various Primary Care services."

Furthermore, "the new structure will allow for the sizing of work teams, as it will enable the professional promotion of staff, making the specialty of Family and Community Medicine, as well as Primary Care Pediatrics, more attractive," the minister added. On the other hand, the draft Decree also contemplates the creation of the new professional category of auxiliary healthcare staff of Primary and Community Care.

The new model contemplates the implementation of shared demand management procedures, which consists of identifying the real need of the patient and channeling it to the most efficient Primary and Community Care team professional for its resolution according to their competencies, with the least delay and the greatest possible resoluteness.

To this end, the new service and section chiefs will be responsible for implementing the appointment circuits, monitoring access difficulties to services, supervising shared management circuits, and agendas.

The minister stated that the purpose of this model "is to offer the patient a quality care response in the shortest possible time and in the most efficient way, also guaranteeing equitable access for people to all healthcare services of the Valencian health system."