Out of Hours Care

1
Out of Hours Care

• Past present and future
• Heidi Wright Sept 09

2
Past

• 24 hour care by own GP

3
History locally

• Previously we did our own on call
• Call out frequency was very varied but often less
  than 5 calls overall
• By 1997 the coop had been established

4
Co-op aka DMS

• This was initially staffed by local GP
  principals(and registrars,being supervised)
• Monthly commitment was 2 shifts and 2 standbys or
  3 shifts, a shift being 4 hours day time to 11pm
  or an overnight ( no EWTD to complicate things!)

5
2004

• New GP contract negotiated nationally
• Meant GP practices could opt out of OOH care
  after 1830h
• Cost to an individual- 6k a year
• Could happily opt in to continue working for the
  co-op
• PCTs were now responsible for OOH care provision
  not the GP

6
2004-2009 Locally

• NHSd launched
• Far fewer local principals working for OOH and
  more from elsewhere in UK and EU
• Development of the role of an ECP
• Development of the Walk In centre
• Change from DMS TO DHU with expanded roles
  and area covered

7
Future?

• Probably more of the same
• Possibility of a change in government leading a
  change in OOH care
• Will there be an extension of core hours agreed
  nationally?

8
Elsewhere

• Be aware of different care models especially in
  Rural and Remote areas
• Eg Highland and Islands of Scotland Wales
• Often GPs superbly well trained in pre-emergency
  care with regular BASICS/ATLS etc courses
• V difficult to get cover, utilisation of other
  healthcare workers being brought in, transfer
  times longer etc.

9
TOP TIP

• Remember to add this to your e-portfolio and link
  to curriculum statement on OOH!