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Scottish GPs refuse to take back OOH responsibility



By Ian Quinn

GP leaders in Scotland have withdrawn proposals to take back commissioning responsibility for out-of-hours care, after fears from grassroots GPs that they would end up having to provide the service.

A final report by BMA Scotland on the future of general practice has dropped the wording of draft proposals to create joint commissioning bodies run by GPs and NHS managers.

Under the draft plans revealed last year, BMA leaders had said that ‘the loss of GP leadership and involvement in out-of-hours care has led to reduced confidence and satisfaction in the service’.

It added: ‘This could be addressed by increasing GP involvement by, for example creating opportunities for GPs to be involved in the commissioning and delivery of out-of-hours services.’

However, the final report, following consultation with Scottish GPs, does not go anywhere near as far.

It says: ‘There was strong support from within the profession and public for greater involvement of GPs in planning and development of out-of-hours services. There was a desire from the public for GPs to be more prominently involved in out of hours care, particularly in rural communities.’

But it adds: ‘While many GPs continue to be involved in the delivery of out-of-hours services, GP respondents said it would be completely impractical to return to a situation where sole responsibility for delivering out of hours services lay with GP practices because of the increasing volume of calls out of hours and the intensity of daytime work.’

The report’s main recommendation instead is for the Scottish Government to do more to raise awareness and standards of NHS 24 – the Scottish equivalent of NHS Direct – which triages all out-of-hours calls in the country.

Dr Dean Marshall, chair of the Scottish GPC, denied patients had lost confidence in the system since GPs stopped being responsible, but admitted there were problems recruiting GPs for shifts in rural areas.