With reference to my previous response of 27th Feb. 2016 on the subject of the diagnosis of sepsis and its relation to the William Mead case which Prof. Modi commented on, I am pleased to see that at last the BMJ is giving publicity to her views on the decline in GP out-of-hours services which she describes, quite rightly, as a great loss. I also agree with Dr Mann's remarks to the effect that clinicians who work only in office hours Mon - Fri, without clear arrangements for OOH cover, are not so much providing a service as indulging in a paid hobby. Dr Roland tells us that few GPs want to provide OOH services, in which case they should be ashamed of themselves for they are accepting the pay and the privileges without accepting the responsibilities that all clinicians should be willing to shoulder.
The current state of GP out-of -hours cover is unsafe and unsatisfactory. Numerous examples of this could be quoted over the last 12 years, not a few resulting in avoidable deaths. The very idea of unqualified call-handlers triaging patients, including young children, is manifestly unacceptable. The decision by GPs taken in 2003 and implemented in 2004 to be able to opt out of OOH care was unworthy of the profession, of which I was a member for 30 years, I am glad now that, at long last, at least two senior consultants are making their views plain on this matter. Martin Roland's tone seems a bit too complacent in accepting the status quo, for instance when he talks of GP OOH cover depending "a varying sort of relationship with an A&E Dept" - that is not good enough.
I appreciate that General Practice is having a difficult time at present what with increasing work load and a recruitment crisis but its reputation will not be restored until the OOH issue reaches a satisfactory conclusion and this must involve taking on a fair share of OOH work.
Rapid Response:
Re: How to fix out of hours care
With reference to my previous response of 27th Feb. 2016 on the subject of the diagnosis of sepsis and its relation to the William Mead case which Prof. Modi commented on, I am pleased to see that at last the BMJ is giving publicity to her views on the decline in GP out-of-hours services which she describes, quite rightly, as a great loss. I also agree with Dr Mann's remarks to the effect that clinicians who work only in office hours Mon - Fri, without clear arrangements for OOH cover, are not so much providing a service as indulging in a paid hobby. Dr Roland tells us that few GPs want to provide OOH services, in which case they should be ashamed of themselves for they are accepting the pay and the privileges without accepting the responsibilities that all clinicians should be willing to shoulder.
The current state of GP out-of -hours cover is unsafe and unsatisfactory. Numerous examples of this could be quoted over the last 12 years, not a few resulting in avoidable deaths. The very idea of unqualified call-handlers triaging patients, including young children, is manifestly unacceptable. The decision by GPs taken in 2003 and implemented in 2004 to be able to opt out of OOH care was unworthy of the profession, of which I was a member for 30 years, I am glad now that, at long last, at least two senior consultants are making their views plain on this matter. Martin Roland's tone seems a bit too complacent in accepting the status quo, for instance when he talks of GP OOH cover depending "a varying sort of relationship with an A&E Dept" - that is not good enough.
I appreciate that General Practice is having a difficult time at present what with increasing work load and a recruitment crisis but its reputation will not be restored until the OOH issue reaches a satisfactory conclusion and this must involve taking on a fair share of OOH work.
Competing interests: No competing interests