BMJ 1996;312:352-356 (10 February)

General practice

Future provision of out of hours primary medical care: a survey with two general practitioner research networks

Val Lattimer, South and West Regional Health Authority research student,a Helen Smith, director, Wessex Primary Care Research Network,b Pali Hungin, director, Northern Primary Care Research Network,c Alan Glasper, professor of nursing,d Steve George, senior lecturer in public health medicine a

a University of Southampton Wessex Institute of Public Health Medicine, Level B, South Academic Block, Southampton General Hospital, Southampton SO16 6YD, b Aldermoor Health Centre, Southampton SO16 5ST, c The Health Centre, Eaglescliffe, Stockton-on-Tees, Cleveland TS16 9EA, d University of Southampton School of Nursing and Midwifery, Level A, South Academic Block, Southampton General Hospital, Southampton SO16 6YD

Correspondence to: Dr George.

Abstract

Objective: To ascertain general practitioners' views about the future provision of out of hours primary medical care.
Design: Self completing postal questionnaire survey.
Setting: Wessex and north east England.
Subjects: 116 general practitioners in the Wessex Primary Care Research Network and 83 in the Northern Primary Care Research Network.
Main outcome measures: Intention to reduce or opt out of on call; plans for changing out of hours arrangements; the three most important changes needed to out of hours care; willingness to try, and perceived strengths and limitations of, three alternative out of hours care models--primary care emergency centres, telephone triage services, and cooperatives.
Results: The overall response rate was 74% (Wessex research network 77% (89/116), northern research network 71% (59/83)). Eighty three per cent of respondents (123/148) were willing to try at least one service model, primary care emergency centres being the most popular option. Key considerations were the potential for a model to reduce time on call and workload, to maintain continuity of care, and to fit the practice context. Sixty one per cent (91/148) hoped to reduce time on call and 25% (37/148) hoped to opt out completely.
Conclusion: General practitioners were keen to try alternative arrangements for out of hours care delivery, despite the lack of formal trials. The increased flexibility in funding brought about by the recent agreement between the General Medical Services Committee and the Department of Health is likely to lead to a proliferation of different schemes. Careful monitoring will be necessary, and formal trials of new service models are needed urgently.

Key messages

  • Key messages

  • Over 80% of general practitioners in two research networks were willing to try a new out of hours service for their practice--either a primary care emergency centre, a telephone triage service, or a cooperative; cooperatives were the least favoured option

  • The most important changes needed to out of hours care concerned financial arrangements, regulations, and patient education

  • Formal trials of new services are needed before the opportunity to collect baseline data is lost


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

GPs in Glasgow are in favour of primary care emergency centres
James O'Neil
BMJ 1996 312: 1610. [Extract] [Full Text]

This article has been cited by other articles:

  • Grol, R., Giesen, P., van Uden, C. (2006). After-Hours Care In The United Kingdom, Denmark, And The Netherlands: New Models. Health Aff (Millwood) 25: 1733-1737 [Abstract] [Full text]  
  • Magin, P, Adams, J, Ireland, M, Joy, E, Heaney, S, Darab, S (2006). The response of general practitioners to the threat of violence in their practices: results from a qualitative study. Fam Pract 23: 273-278 [Abstract] [Full text]  
  • Leibowitz, R., Day, S., Dunt, D. (2003). A systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction. Fam Pract 20: 311-317 [Abstract] [Full text]  
  • Ashworth, M., Clement, S., Wright, M. (2002). Demand, appropriateness and prescribing of 'lifestyle drugs': a consultation survey in general practice. Fam Pract 19: 236-241 [Abstract] [Full text]  
  • Kersnik, J. (2000). Observational study of home visits in Slovene general practice: patient characteristics, practice characteristics and health care utilization. Fam Pract 17: 389-393 [Abstract] [Full text]  
  • Jones, R. (2000). Primary care research: ends and means. Fam Pract 17: 1-4 [Full text]  
  • Lattimer, V., George, S., Thompson, F., Thomas, E., Mullee, M., Turnbull, J., Smith, H., Moore, M., Bond, H., Glasper, A. (1998). Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial. BMJ 317: 1054-1059 [Abstract] [Full text]  
  • Neuberger, J. (1998). Primary care: core values Patients' priorities. BMJ 317: 260-262 [Full text]  
  • O'Neil, J. (1996). GPs in Glasgow are in favour of primary care emergency centres. BMJ 312: 1610a-1610 [Full text]  
  • Wright, J., Prasad, N., Dalrymple, G. (1996). Emergency referral letters from deputising doctors need to be improved. BMJ 312: 1304-1304 [Full text]  
  • Heaney, D., Gorman, D. (1996). Primary care out of hours. BMJ 312: 1303b-1304 [Full text]  
Access jobs at BMJ Careers
Whats new online at Student BMJ