Increasing patient participation using an extended consultation: an inner city study.

An inner city practice in Birmingham has developed a new style of extended consultation to increase patient participation in primary care, based on previous initiatives in the practice, in particular allowing patients access to medical records, adopting an open reception style, and including consultations with a nurse practitioner. In a three stage consultation lasting approximately 30 minutes patients were offered a session with a receptionist for assisted access to medical records, a session of 15-20 minutes with a doctor or nurse and a self help session with a receptionist. This extended consultation was welcomed by patients, who showed a marked degree of participation, and it also increased the satisfaction and cooperation of project staff. This type of consultation provides a model for increasing patient participation in general practice.