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Letter of the week: GP-led out-of-hours services under threat

I am the chair of St Helens Rota, an out-of-hours provider in St Helens, Merseyside, and am writing regarding your story about the difficulties providers are having in filling shifts.

For 30 years we have provided our own out-of-hours service and – when the new contract came in – the vast majority of local GPs chose not to opt out.

Our service has always been GP led and in the past most of our deputies have been local practitioners.

Last year, for just over 23,000 calls, we had two written complaints (for a population of greater than 200,000).

Now, as GP morale falls, we find people less willing to or capable of doing the work. We have managed to keep costs reasonably equated to the 6%

of global sum GPs lost when they gave up out-of-hours responsibility. We are being hammered by the work needed to pass CQC registration, but

are fighting to keep going as we still feel the service justifies its existence.

Around the corner is 111, which threatens the jobs of our own call-handling staff and – I suspect – the future of the service. Whenever anyone mentions our name at local PCT meetings they have the look of someone who finds dog shit on their shoe.

Nobody will ever convince me that the best triage is other than that between a doctor and patient, and not some faceless person in a nameless place looking at an algorithm on a computer screen.

God help general practice.

From Dr Timothy Whittaker, St Helens, Merseyside