Urgent action needed to tackle out-of-hours crisis in Wales, says RCGP

Urgent action is needed to cope with mounting pressure on out-of-hours services in Wales, the RCGP has said.

RCGP Wales chair Dr Rebecca Payne (Photo: Pete Hill)
RCGP Wales chair Dr Rebecca Payne (Photo: Pete Hill)

The college has published an action plan calling for steps to be taken immediately to improve out-of-hours care.

Meeting urgent needs: Improving out-of-hours services in Wales says that weaknesses in the system across the country are compromising patient care and increasing pressure on emergency departments. It sets out five steps that could help improve out-of-hours services.

The plan comes in response to a report published by the Board of Community Health Councils in Wales - an independent NHS watchdog - which found that every health board in the country identified their out-of-hours services as ‘fragile’.

Meanwhile, findings published yesterday by the BBC showed that hundreds of GP out-of-hours shifts are being left unfilled across Wales, with several health boards failing to provide any GP out-of-hours cover at all at times.

A recent report by the Wales Audit Office found out-of-hours services to be ‘under strain’ and not meeting national standards.

RCGP Wales chair Dr Rebecca Payne said: ‘Patients' needs don't stop when practices close but evidence is mounting that accessing out of hours services is too difficult.

‘GPs are going above and beyond to try and make things work, but the support to deliver services simply isn’t there and patients are feeling the effects.’

Out-of-hours crisis

The RCGP plan outlines five ‘essential and achievable steps’ to help turn around GP out-of-hours care in Wales. These include:

  • Increasing the number of call handlers.
  • Utilising a wider primary care team (including paramedic practitioners and pharmacists) so that patients can see the right person at the right time.
  • Making use of technology.
  • Establishing a clear national out-of-hours framework and distributing national guidance to clinicians.
  • Addressing the wider issues facing general practice in the current climate.

Dr Payne added: ‘The recommendations in our plan are essential, but also achievable. We are not asking for the moon; call handlers should be relatively simple to recruit, they are trained to follow clinically developed pathways and increasing their number would deliver a clear benefit. Patients being unable to access services is a waste of their time and diverts demand to other areas of the health service.

‘Wales also needs out-of-hours services to reflect the modern nature of the primary care workforce, while ensuring services are aided by technology that already exists. Another improvement would be something as basic as staff having clearer guidance to work to.

‘The recommendations outlined in our plan would lead to a real improvement in services. Welsh government and local health boards need to recognise the scale of the problem and implement these solutions as a matter of urgency.’

'Not unique'

Dr David Bailey, chair of the BMA’s Welsh council said: 'The system as a whole in under a sustained amount of intense pressure. Increased workload from a variety of sources and inadequate resources due to years of underinvestment in both the service and workforce has led to this situation.

'We have put forward a range of solutions to Welsh government and health boards including tailoring offers to the needs of individual GPs (and allied health care professionals) together with some solutions that need to be taken forward nationally.

'These solutions need to be urgently implemented together with additional mechanisms to ensure the workforce is valued and working in supportive safe organisations so that they can build a safe sustainable out-of-hours service for Welsh patients that is fit for purpose and to stop the service from failing any further.'

Last month, GPonline reported that GP out-of-hours services in Scotland were being hit by closures amid a workforce crisis.

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