Out-of-hours doctors 'need to be familiar with local NHS'

Only doctors familiar with local health services should provide out-of-hours primary care, according to a report in the BMJ.

The paper by Dr Paul Cosford and Dr Justyn Thomas from NHS East of England called for an end to the ‘risky practice’ of bringing in doctors to work short term shifts where they are unfamiliar with local health care. They said this is just one of several wide ranging changes needed to ensure the quality and safety of out-of-hours care.

They also highlighted a need for a review of laws governing the registration of doctors from the EEA. ‘This is not to prevent the free movement of well qualified doctors, but to recognise that healthcare systems differ across the EU, and that doctors’ competence is at least partly specific to the system in which they work.’

The paper also advocates changes to the PCT performers' list system, which allows a doctor on one list to practice anywhere in England. This system should require GPs to be on the list of the PCT where they work, with the extra provision that they should be able to enter more than one list if they have good reason, the report said.

‘National clinical leaders in the GMC, BMA, DoH, SHAs, royal colleges and others must also advocate the changes necessary in this service,’ the paper concluded.

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