The pressures on the out-of-hours service are approaching critical. I’m the standby doctor for our excellent out-of-hours service, but I cover an area that stretches 800 square miles on the evening shift because there is nobody else.
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It only takes two sick people at either end of the patch to result in doctors having to be pulled in from other patches, leaving their area uncovered; we are constantly trying to firefight demand.
Because of the rota gaps and pressure on resources, we will have to employ a lot of urgent care practitioners and paramedics to help us cope. They are skilled but they’re not medically trained, meaning the doctors on duty will also have to provide remote advice.
When we are busy, the callback times can be four or five hours, and our time is often taken up dealing with inappropriate requests. A couple of months ago, a guy phoned up to say his girlfriend was coming over and he realised he hadn’t ordered his Viagra, so could we supply it. We have a contractual duty to call that man back and explain why his request was inappropriate.
It is falling due to a dwindling band of older GPs like me to deliver out-of-hours care and it is probably not sustainable. Indemnity costs are one reason for this situation, but also most out-of-hours GPs haven’t had a pay rise for 10 or 15 years. My rate of pay is £65 an hour – our locums charge more than that for a day shift.
Dr Alan Woodall is an out-of-hours GP in England and a GP partner in Wales