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Scots GPs warn of out-of-hours crisis

Out-of-hours funding shortfalls and complaints over IT failures dominated the Scottish LMCs conference last week – reports by Nerys Hairon

GPs in Scotland have warned that plans for out-of-hours care under the new contract are 'lurching from crisis to crisis'.

As local health boards prepare to take over responsibility for out-of-hours provision this year, LMCs have called on the Scottish Executive to scrap the nurse-led helpline NHS 24 and produce 'locally agreed solutions' to the crisis.

GPs have demanded that the Executive fund shortfalls for out-of-hours cover – in some areas deficits are as high as £4 million – while insisting they must be paid market rates for the work.

The Scottish LMCs conference last week deplored the £47 million current annual cost of NHS 24, branding the helpline 'unwelcome and unnecessary'.

Glasgow LMC secretary Dr Barbara West said the cost per call to NHS 24 was £32 compared with £20 per GP out-of-hours consultation. She attacked the helpline for providing a 'horrendous service', such as sending patients to primary care centres miles from their home.

Dr Huntley McCallum, from Ayrshire and Arran LMC, said the helpline 'distorted clinical priorities' and often ambulances were called even when patients knew they did not need one.

But other LMCs urged GPs to accept that NHS 24 was 'here to stay'. Dr John Garner, from Lothian LMC, said: 'We have to work with it and make it more efficient.'

Tayside LMC secretary Dr Andrew Buist said the only alternative to NHS 24 was to have 15 separate call-handling services run by health boards.

NHS 24 said some of the points made by GPs were 'inaccurate', but it accepted there were 'areas of our operation that require improvement'.

Dr Brian Robson, NHS 24's medical director, said: 'We feel we are responsive to partners and have received encouraging feedback from them.'

GPs also expressed fears about huge funding shortfalls in out-of-hours services.

Dr Paul Ryan, from Glasgow LMC, said the 'situation in most of Scotland is a

shambles'.

He said Glasgow still had a deficit of £1.3 million. Dr

Peter Dolan said the deficit in the Highlands was between £3 million and £4 million.

But LMCs stopped short of calling for uniform pay rates for night and weekend work across Scotland.

GPC negotiator Dr Peter Holden said the BMA would have to seek legal advice on out-of-hours rates, but said the current suggestions of up to £75 an hour were 'too low' as market rates.

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