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The out-of-hours challenge

There are few issues more controversial and at times corrosive than the debate over out-of-hours cover, and the degree to which GPs should be responsible for it.

There are few issues more controversial and at times corrosive than the debate over out-of-hours cover, and the degree to which GPs should be responsible for it.

When GPs won the right to opt out of out-of-hours, most were relieved and elated, after years of onerous, under-valued and under-paid work.

But for some, mixed in with the elation was a nagging, almost-guilty doubt – a concern that with PCTs taking on responsibility for out-of-hours care, the quality of services for patients would suffer.

Confidence slumping

This week, Pulse publishes the results of a major, long-running investigation into out-of-hours care, which is bound to intensify those concerns. Our investigation reveals that GPs' confidence in out-of-hours services has slumped since the opt-out, that patients are nervous and confused about how to access services, and that there is an astonishing degree of variation in the amount trusts spend of on-call cover.

The results present a clear challenge to everyone involved in running out-of-hours services. PCTs need to up their game, while the Government needs to give trusts more help in defining what an optimum service might look like, and how much it should cost.

But the findings challenge GPs too. The profession is clear that it does not want to take back responsibility for out-of-hours, and nor should it. But it is GPs who know best how to run out-of-hours services, and they must give trusts the benefit of that expertise.

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