Out-of-hours care 'inadequate and inflexible'Patients forced to go to hospital, says study
29 October 2007
People are being forced to turn up at hospitals because the existing system of out-of-hours care is ‘largely inadequate and inflexible’, says a new report.
The Royal College of Physicians (RCP) says that often there is nowhere else for ill people to go to get the reassurance and care they need.
The study says that patients should, instead, be directed as soon as possible to the most appropriate doctor who can diagnose their condition quickly.
This should happen no matter what time of day it is and be supported by round-the-clock diagnostic facilities such as X-rays and blood tests.
Since new GP contracts were introduced in 2004, many family doctors have opted out of providing a round-the-clock service.
Instead care outside of office hours is in the hands of primary care trusts (PCTs), which employ in-house GP teams, private firms and locums.
The RCP report says there needs to be ‘an expansion of the range of services, providers and facilities offering unscheduled and acute medical care in the community’.
The report also recommends local ‘navigation hubs’ be set up to direct people to the most appropriate medical service.
And in large hospitals, the emergency department, acute medical unit, critical care and ambulance services should be located near to each other so that patients get to the right place quickly.
Standard of care
Professor Ian Gilmore, RCP President, said: ‘For doctors, nurses, managers and all those involved with the care of acutely ill patients, this task will not be easy, but the status quo is not an option if we are to give these patients a consistently high standard of care.’
Health minister Ben Bradshaw said: ‘We welcome this report and are already making sure that people have access to care around the clock.
‘Primary care trusts must deliver high-quality out-of-hours care, and in addition, patients have access to a range of other services that can provide urgent care out of hours including NHS Direct and NHS walk-in centres.
‘We have invested record amounts in out-of-hours services and patients are seeing the benefits - eight out of ten patients say that they are satisfied with the service, and six out of ten rated the service as excellent or good.’
Which? health campaigner Frances Blunden said: 'This report reinforces the key messages from Which?'s study of out-of-hours care in 2006.
'Services across the country are inconsistent and patchy and do not represent a consistent or coherent patient-centred response to patients needs. Consumers want prompt reassurance and attention for their problem with effective and timely care but what they are experiencing are long waits or having to travel significant distances to get treatment, particularly in rural areas.
'They often have to go through multiple stages to get treatment, having to repeat information or being referred on from other services that cannot deal with their problem. They do not want to be passed from pillar to post, and if they feel that going to a particular stage (such as NHS Direct) was a waste of time they will skip that stage next time.'
If you're unhappy with the standard of your healthcare, take a look at our guide to making a complaint.