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At the heart of general practice since 1960

GP proposes new model for out-of-hours care

Dr Krishna Korlipara –

former NAGPC president

Collaborative medical services (CMedS) will be a natural successor to GP co-operatives.

CMedS will guarantee a doctor for any patient who asks to see a doctor out-of-hours, not a nurse or another health care worker. It continues with collective ownership resting among doctors who remain responsible for the standards of care delivered.

Under a community benefit society nurses and other health care workers will treat minor illnesses. Doctors will only see some patients, even though patients expect to see a doctor especially out-of-hours when they think their illness cannot wait till morning.

CMedS can work with PCTs both in hours and out-of-hours, by finding the

doctors with appropriate skills to deputise at night, pro-

viding locums day or night,

offering enhanced services and also chronic disease management.

Dr Mark Reynolds –

chair of the NAGPC

We jointly developed the CBS model along with the think-tank Mutuo and the Department of Health, as just one option for future company structures.

Yes, it does have both ours and the Government's backing, but so does the existing co-op model.

Control of a CBS will rest with key staff, especially clinicians. The doctor-only model of out-of-hours services may not be sustainable, and why should it be when teamwork can reduce the load on GPs?

All the evidence is that other professions are just as good at some aspects of out-of-hours care, as long as there are GPs behind them.

It's about grassroots involvement, ownership by the clinical and managerial workforce, with control vested largely in the frontline clinicians but with input from other interested organisations such as ambulance trusts, A&E and PCTs.

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