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Out-of-hours: Patients now fear for safety

Patients are increasingly unhappy with the quality of out-of-hours care and many fear for their safety as a result, a large-scale survey has revealed.

The research, carried out among more than 3,000 patients on behalf of Pulse by the online market research company Opinion Health, found many patients were deeply concerned over the standard of their out-of-hours service.

One in five said they received ‘poor' or ‘very poor' care the last time they sought help out of hours. And patients were confused and bewildered by the reconfiguration of out-of-hours care since 2004.

One in three said they did not know how to contact their out-of-hours service, while more than half believed their area had stopped running one.

Almost half reported feeling ‘less safe' since PCTs took over responsibility for provision. Forty percent said the quality of care was worse, with just one in 20 saying it had improved.

Reacting to the survey, the Patients Association said standards were ‘definitely worse' but this was not being reflected in official figures. ‘If you compare this service with an airport, where safety and 100% service is what they aspire to, the health service should be the same.'

Dr Ronald Carter, a GP in Milton Keynes and director with clinical governance responsibility for Milton Keynes Doctors on Call, said: ‘Maybe we as a profession should be complaining much more on patients' behalf at how limited a service we can provide them, in comparison with how good a service we could provide.'

Dr Jamie Nicholls, a GP in Hockley, Essex, said: ‘Communication is a problem. Patients seem confused by having a paramedic visit for over half an hour, filling in a very detailed form, for a simple matter a GP would have dealt with in a couple of minutes.'

The survey suggested GPs were being replaced by nurses and emergency care practitioners – with just 57% of patients seeing a doctor the last time they sought out-of-hours care.

In April, Pulse revealed over half of trusts had cut back on GP cover since 2004.

Dr Helen Joesbury, a GP in Sheffield, said: ‘Now patients are triaged by NHS Direct and nurses first, so they can no longer be guaranteed a GP consultation – which increases referral back to practices the following day.'

Patient survey findings

• 51% of patients think GPs no longer work out-of-hours
• 48% feel 'less safe' since PCTs took over responsibility for out-of-hours provision
• 5% say provision has got better
• 57% saw a doctor the last time they sought out-of-hours care

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