When I say, ‘Out of hours service’, what do you think of? Yes, OK, services outside our 8am-6.30pm contracted hours. Go on. Somewhere in your mind is the word emergency, isn’t it?
Think again. As this story shows , up to a quarter of OOH calls these days are for repeat prescriptions. That’s right: asthma inhalers, contraceptive pills and so on. Treatments that, by definition – or, at least, by the definition of ‘repeat prescription’ – are not urgent.
Apparently, the peak occurred on the Royal Wedding bank Holiday last year, which surely begs some sort of joke, except that a) I can’t think of one b) It’s not funny.
My Pavlovian response is to blame the Government for promoting a 24/7, access-all areas, choice-laden, all-U-can-eat NHS. And, obviously, to blame the punters, too – particularly as they now live in a world where, with pharmacy repeat prescription services, on-line ordering facilities and so on, it really is as easy to request your Diskhaler as it is a Deep Pan Pepperoni. Dr O’Malley, of Mastercall Healthcare, might politely suggest we need a ‘mature conversation’ with patients about the OOH service, but, hey, have you ever tried that? No, they just need to be soundly spanked and sent to bed early, preferably before 6.30pm.
But, to be honest, we should look at ourselves, too. It must have occurred to us, way back when, that an OOH service that we no longer had responsibility for would pretty soon become irresponsible. And you don’t arrive at a 25% OOH repeat script rate overnight. You only reach this pinnacle of instant gratification by caving in to patient demand – an
approach that now tends to be inculcated in registrars as they see hard-pressed and complaint-phobic OOH trainers doing what’s expedient rather than what’s appropriate.
I’m looking forward to CCGs sorting it all out, though – presumably in the same way that you can sort out a leaking dam with a finger. In the meantime, we’ve got the Queen’s diamond jubilee public holiday coming up. Anyone for a stint of out of hours? I use the term loosely.
Dr Tony Copperfield is a GP in Essex