Minister admits "unacceptable" out-of-hours visit variations

Tuesday 2nd February 2010

GP's out-of-hours services have "unacceptable" variations in quality depending where they are in the country, the health minister has said.

Mike O'Brien (pictured) said he will publish proposals to improve the system after a Primary Care Foundation study found doctors in the worst areas agree to visit just one in 50 (2%) patients who ask for an out-of-hours home visit.

The report, which appeared in the Daily Mail, said some areas had one GP covering more than 300,000 people at night, and the best area could only fulfil one in four (25%) requests for a night or weekend visit.

Telephone diagnoses also varied among England's PCTs, with some giving 70% of patients advice on the phone instead of visiting, while others managed to keep it at 20%.

Mr O'Brien said on GMTV that he had a report that said the current system had improved since 2004, which he commissioned last year and had been on his desk for a couple of weeks.

He said the report found "there is an unacceptable level of variation between the PCTs, who are the funders of the out-of-hours services," but was waiting for a Cambridgeshire inquest to conclude before he published it.

Proposals should include some minimum government standards and involving local doctors to help meet local needs, he said.

Copyright © Press Association 2010

Department of Health

Related MiP blog: Out-of-order? Three letters to tax the Tories: OOH

Your comments (terms and conditions apply):

"Getting local doctors to help meet local needs – well, there is a recipe for disaster! Most underperforming services are ones provided by GP co-ops and PCT provider arms – community foundation trusts (CFTs) now. Just look at the Worcester area – a disaster under a CFT and now sorted out by, wait for it, TCN!!! Most poor call handling at the front of OOH services (often directed by SHA or PCT intervention) is perpetrated by NHS(D) and ambulance trusts. In one PCT in the UK, only the OOH provider completed doctors' appraisals last year – none were conducted and checked by the PCT of the "local GPs". In one OOH provider, the RCGP Audit Toolkit identified 'local GPs' who scored less than 50% in the audit – repeatedly! Oh, and the sector does have minimum government standards – they are called NQRs and there are 13 of them – and they produce a service that is more regulated, managed and timely for its patients than any GP practice in the land – three minutes for an emergency call-back, and access to a GP in one hour if you are a walk-in – most GP practices don't allow walk-ins and where they do you'll wait longer than an hour – call ahead and you'll be lucky to be seen in 24-48 hours. OOH now means 'out of hysteria' – referring to the reaction of those who are in charge but haven't a clue about what they manage" – Chris, Midlands

"Is this not the wrong way round? Surely the area visiting 50% of patients has it wrong? Reinforcing medicalisation and a pill for every ill presribed by a doctor instead of sensible self-care as per your other article [click here for story – Ed] is much more sensible. Patient need to take responsibility for their own welfare to a much greater extent than they do currently, not less. As we all know, so much of what is seen are really minor self-limiting illnesses, and two paracetamol or similar really is all that is needed. Surely all patients should be expected to provide at least that for themselves?" – Name and address withheld

Feedback

What's your view? Do you agree that there are serious variations in OOH quality across the country?

Name:
Email:
Location:

We welcome all feedback. However, we cannot publish anonymous comments, so please supply your name and location. Your details will not be displayed if you so request. To protect privacy we never publish email addresses.