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Independents' Day

Out-of-hours: Major GP concern over care standards

Most GPs believe the standard of out-of-hours care has fallen since they passed responsibility to PCTs.

A national survey of 880 GPs, run by the Medical Protection Society on behalf of Pulse, found many had serious concerns over the standard of out-of-hours care.

But GPs were united in their opposition to taking back responsibility for out-of-hours, with some willing to resign rather than see their contracts rewritten.

While most respondents still believed the service in their area was at least ‘satisfactory', six out of 10 think care is worse than in 2004.

Almost half had seen their patients complain about out-of hours-care in the last year, with some reporting dozens of complaints. Workload of GPs on out-of-hours shifts has increased by 75%.

Dr Adrian Hamilton, a GP in Waterlooville in Hampshire, said: ‘I've had two very unfortunate incidents in the last 18 months where the doctor on call has not acted to the standard I would expect of a GP.

‘In one case, over a year on, I am still dealing with the trauma the relatives experienced watching their loved one dying in extreme distress.'

Private out-of-hours providers scored particularly badly. Some 19 % of GPs covered by private providers described out-of-hours cover as less than satisfactory, compared with 12% of all GPs.

And 58% of GPs covered by private providers reported patient complaints in the past year, compared with 44% of all GPs.

Dr Richard Vautrey, GPC deputy chair, said: ‘Private organisations often cut their costs by reducing the numbers of GPs they employ, so it is no surprise when patients are less satisfied.'

Many GPs blamed the decline in standards on the increasing role of non-GPs.

Dr Peter Holden, GPC negotiator and a GP in Matlock, Derbyshire, said standards were ‘much worse', and that he had received two ‘very serious' complaints from patients.

‘Stop inappropriate skill-mixing with non-doctors – it is conning the public,' he said.

But most GPs were adamant they did not want the responsibility for cover back. Just 1.4% said they would readily take back responsibility, with 21.5% saying they would if paid adequately.

An MPS spokesperson said the findings showed there had been a ‘change in culture'. He added: ‘Being a GP used to be a way of life and they were available 24/7, but innumerable changes to the way care is delivered have depersonalised it.'

Key findings

• 60% think out-of-hours care worse than in 2004
• 44% GPs have had patients complain in past year
• 75% increase in workload on out-of-hours GPs
• 33% of GPs currently working out-of-hours
• 0.9% still responsible for running out-of-hours

Survey of 880 GPs carried out by the Medical Protection Society on behalf of Pulse.

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