Organisation of primary care services outside normal working hours

Abstract

Objective-To determine the use and organisation ofout ofhours services in primary care.Design Only two cooperatives were in areas with extensive use ofdeputising services.Conclusion-Methods of providing out of hours care are changing, and without good information systems family health services authorities will not be able to monitor the effect on quality and cost effectiveness ofcare.

Home visiting by general practitioners in England and Wales

“…Because the national morbidity survey did not separate visits made during normal working hours from those made out of hours, we were not able to examine factors associated with out of hours visits. A national survey of family health services authorities found that the average night visiting rate for England and Wales was 35/1000 patients,15 which suggests that nearly one in nine home visits are carried out at night. If the new out of hours primary care centres that are currently being developed reduce the demand for out of hours visits, this will lead to a further fall in home visiting rates.…”

Out of hours

“…Two thirds of all night visits are done by general practitioners (p 1621)11 paid for from net target remuneration funds, at no extra cost to the exchequer. The cost of the remaining third, undertaken by deputising services or large cooperative rotas, count as general practitioners' expenses, which attract additional funding to maintain the net target remuneration figure.…”

Out-of-hours primary care services: Demands and patient referral patterns in a Veneto region (Italy) Local Health Authority

“…Appropriate OOH services are important for a wellfunctioning h24/7/365 primary health care system, and any efforts to redesign a country's primary health care organizations in order to improve their quality of care must necessarily discuss how OOH care is organized too [3,4]. OOH services are organized differently in different countries [3][4][5][6][7][8], but are frequently based on family doctors operating in small-or large-scale organizations. In their review of the literature, Van Uden et al [9] found at least seven common models for providing primary care to patients out of hours, while a more recent analysis by Linda Huibers et al [10] identified nine organizational models currently in use in various parts of Europe.…”