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At the heart of general practice since 1960

Collaborative versus community: the champions put their cases

GPs have spoken out in protest over the first PCT to offer a GP-less out-of-hours service.

Lincolnshire South West Teaching PCT has decided to run a nurse-only service during the red-eye shift of 11pm to 8am, to relieve pressure on GPs.

But despite PCT claims that local GPs backed the move, Lincolnshire LMC medical secretary Dr Paddy Twomey said GPs still had worries.

'So far it's worked well but there is concern among GPs about possible incidents when a GP will be needed,' he

said.

'That hasn't happened yet, but when it does, what will happen?'

He added that while the nurses involved were highly trained, there was still a 'massive difference' in their skill level compared with GPs.

The move has also been criticised by the National Association of GP Co-operatives. A spokesman said: 'We wouldn't advocate a GP-less service – there is a huge

need for highly trained and skilled GPs to be available if you want to offer a high-quality service.'

The nurse-led service also appears to defy health minister John Hutton, who in March said it was 'absolutely essential' that a patient had access to a GP out-of-hours.

Lincolnshire South West PCT's professional executive committee chair Dr Ruth Livingstone said nurses could gain access to a GP during this time for advice.

Dr Livingstone also suggested that other rural PCOs could follow, with a number already contacting the trust for more information.

The Department of Health is soon to publish full guidance on GP involvement in out-of-hours services.

GPC chair Dr Hamish Meldrum said: 'I feel that while this may not be putting patients' lives at risk it may mean that nurses will err on the side of caution and more patients than need to be will be admitted to hospital.'

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