Social Enterprise and Committed Local GPs is the way forward for Out of Hours care: Message to Jeremy Hunt from UHUK

The Secretary of State’s comments on out of hours care are grossly unfair and misguided, and will be met with disbelief from millions of patients who have been well served by our services over the last decade.

Out of hours organisations deal with about 8 million calls each year, care is very accessible, and includes good services to patients with long term conditions and the seriously ill.

theme366_logoDr Mark Reynolds, Chair of Urgent Health UK, said: “Over 90% of callers to social enterprise out of hours services are kept in the community rather than having to go to hospital – a figure which extrapolates to well over 7 million people nationally each year and compares extremely favourably with that achieved by other models.

Urgent Health UK members’ average onward referral rates are:

A&E                3.8%

Hospital          3.1%

Ambulance      2.4%

Dr Reynolds added: “From these figures and from our high levels of patient satisfaction it is clear that social enterprise out of hours provision, properly funded and involving committed local GPs is the way forward and we would welcome any changes which further promote this model and encourage GPs to get involved.”

Demand has increased over the years across all healthcare sectors and out of hours services have coped better than most so to blame just OOH providers for the rise in A&E attendances is outrageous.

Out of hours models of service delivery and levels of funding vary across the country but Social Enterprise providers deliver high quality care to nearly 50% of the population and many are represented by Urgent Health UK whose members cover 30% of the population.

The doctors who work in our organisations are almost universally the same as those who work in local practices, taking a turn in the rota to care for patients whilst surgeries are closed – so they have never really given up their commitment to out of hours care although they have not been directly responsible for providing or commissioning the service since 2004.

A return to the out of hours arrangements prior to 2004 is unrealistic because the best modern properly funded out of hours services are of much higher quality and are much safer than the old models.

brisdoc_0.jpgIt is not safe for GPs to work and be personally on call 24 hours a day, 365 days of the year and today’s Social Enterprise providers arose from collaborative partnerships of local GPs sharing the workload and working to clearly specified quality standards.

The quality standards UHUK members work to are national ones covering a range of indicators and these are the key ones:

  • All calls must be answered within 60 seconds
  • Life threatening conditions must be identified and passed to the ambulance service within 3 minutes
  • Clinical assessment is started within 20 minutes of the call being answered for urgent calls and within 60 minutes for all other calls
  • At the end of the assessment, the patient is made clear of the outcome, including the timescale within which further action will be taken and the location of any face-to-face consultation

Face-to-face consultations (whether in a treatment centre or in the patient’s home) are started within the following timescales, after the clinical assessment has been completed:

  1. Emergency within 1 hour
  2. Urgent within 2 hours
  3. Less urgent within 6 hours

Patients unable to communicate effectively in English are provided with an interpretation service within 15 minutes of initial contact. Providers must also make appropriate provision for patients with impaired hearing or impaired sight.

However Urgent Health UK goes a huge step further with all members externally audited and benchmarked against each other on patient satisfaction and clinical quality as well as the national quality requirements – and they also compare their onward referral rates to the emergency services (ambulance, A&E and emergency admission) with a continual drive to improve both their systems and their integration with their local health economies in order to minimise this figure where appropriate to do so.

We would like to extend an open invitation to Jeremy Hunt to visit us to hear the full story, review our quality programme, and to see the thousands of compliments received by hard-working GPs and staff.

See @jagpr blog about OOH



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