Wide variation in out-of-hours care

Patients in parts of the UK are 18 times more likely to be hospitalised after a visit to out-of-hours services than patients elsewhere, a report shows.

The Primary Care Foundation (PCF) report compares GP out-of-hours services at 61 anonymous primary care organisations (PCOs), and found no clear reason for huge variations in cost and quality of services.

It found demands on services varied by a factor of two, but their costs by a factor of four.

The proportion of patients later hospitalised, meanwhile, varied by a factor of 18.

PCF partner Henry Clay warned that neither the type of provider offering a service, nor the range of clinicians staffing it fully explained the variation.

While geography and demand clearly affected costs, other factors were at play, he said.

‘Every PCT says we're different, it's more difficult here,’ he said.

‘But I believe the minutiae of ensuring clinical decisions are made consistently are far more important.’

The DoH-backed report aims to allow PCTs and providers to rank their performance against their neighbours.

It found a vast range in the speed of services. One PCT took more than 20 minutes to assess urgent cases in more than 70% of cases. But another assessed nearly 90% of urgent and non-urgent cases in the same time.


  • Read this week’s GP dated 10 April for a full version of this story.

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