Out-of-hours care: do we?

Abstract

The national GP Patient Survey (GPPS), the largest routine survey of primary care patients to be conducted anywhere in the world, has recently provided insights into patients' experiences of out-of-hours patient care in England. ‘Out-of-hours’ refers to that period between 6.30 p.m. and 8 a.m. weekdays, at weekends, and on bank holidays and public holidays.1 Routine data have, until now, been reported for each of England's 8278 practices, 152 primary care trusts (PCTs), and 10 strategic health authorities. GPPS data that were reported recently for each of the 100 out-of-hours organisations currently providing care in England,2 document the patchy nature of the provision, although around two-thirds of responders reported their experience was at least ‘good’. A similar proportion of survey respondents reported that they would know how to contact an out-of-hours GP service, the remaining third reported they would not know how to do this. Many of those in London figure prominently at the lower end of the rankings, but whether this is because of the quality and timeliness of the service or because of the challenges of providing out-of-hours care to some populations is unclear. It is perhaps not surprising to discover that 60 patients in Wales, interviewed as part of a qualitative study of GP out-of-hours service users3 reported in this issue of the BJGP , also reported variations in their experiences of care. The authors call for out-of-hours triage services that are flexible and streamlined. In particular, they note the adverse effect on reported experience when delays and obstacles, such as the nature and duration of questioning and the repetition of administrative information, appeared to block access to the sometimes-elusive goal of a consultation with a doctor. In the GPPS, around a third of recent service users reported that they thought it took ‘too …