GPs overturn scheme to cut out-of-hours visits

UK out-of-hours providers monitor the number of GP home visits and the success of telephone consultations.

A scheme to reduce out-of-hours home visits by GPs has been withdrawn amid complaints from GPs.

Many out-of-hours providers across the UK, such as On Call Care in Kent and Urgent Care 24 in Liverpool, monitor the number of home visits GPs carry out and the proportion of calls GPs can resolve over the telephone to assess performance.

But the East of England Ambulance Service, which runs out-of-hours care in Norfolk and Essex, put such restrictions on eligibility for home visits that elderly patients were forced to travel to an out-of-hours centre.

But restrictions put in place to reduce Norfolk's higher than average number of out-of-hours home visits had been withdrawn amid complaints, said Norfolk LMC medical secretary Dr Simon Lockett.

'It was very prescriptive. They were taking away the freedom to make concessions for certain visits,' he said.

'It was introduced without any discussion.'

The guidance stated that patients should only be seen at home if they have symptoms such as chest pain.

All other calls should be classed as low priority, it said.

Out-of-hours GPs in the area said it was unfair on elderly patients who found it difficult to travel to the out-of-hours care centre - the only one in the county.

'Patients in nursing and care homes must attend the centre if their condition is such that they can travel,' the guidance stated.

A spokesperson for the East of England Ambulance Service said the guidance was being rewritten.

The protocols were taken from Essex, where it 'worked well' according to the ambulance trust.

'Norfolk is rural and I think many of the complaints related to travel,' said a spokeswoman.

The NHS Alliance defended performance management of out-of-hours GPs. A spokesman said comparing the numbers of referrals for prescribing decisions and home visits was an important way to ensure patients receive high-quality care.

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