The problems with out-of-hours stem from the under-pricing of the service before the new contract, which meant the Government could hardly take more money off us for not doing it than we were being paid to do it (‘Buckman bites back over out-of-hours care').
I would be more than happy to go back to the old co-operative system, where doctors and nurses knew the local services and each other and there was even a handover for patients causing concern.
The headline costs are higher, but if you include unnecessary admissions and A&E visits, it must save money and provide
a better service. The problem is, more GPs would be needed so
a different GP could work in the surgery after a night shift. I, for one, would never return to back-to-back shifts.
Practice-based commissioning groups may be ideally situated to talk about out-of-hours cover with their PCT, provided even more money is not taken out of the daytime budget to pay for it.
From Dr Christine Tarala, Colchester
