Is Out of Hours GP Work Safer for the GP?

The question of the safety of out of hours work for GPs is one that is being raised more and more as out of hours services become more popular. One of the biggest causes of complaint amongst patients is the inflexibility of GP hours, meaning those who have non-urgent needs are bound to working hours opening times and no surgery hours at all on weekends. This means people are starting to take advantage of out of hours services, but with a shortage of doctors willing to take on these additional duties – problems may arise. For these reasons, we want to explore out of hours work for GPs as well as the benefits of working out of hours care, for those of you considering this as a possibility for your career path

Background

Out of hours care came under review in 2010 following a number of notable failures. The review found that whilst there were some failings in the system, there were also many examples of good practice. Moreover, those working in out of hours care including doctors, nurses and managers showed a passion for delivering quality care. In 2014, a follow up review was conducted by Professor Steve Field, Chief Inspector of General Practice, who also carried out the original review. He found that whilst some headway had been made, there was still some improvement to be made.

The key findings from the study showed that out of hours care is generally ‘safe, effective, caring, responsive and well led’. Whilst this study showed out of hours care is considered to be safe, the press took a different interpretation of the findings, claiming that ‘GP out of hours services put patients’ lives at risk’. For this reason, many people have a wary view of out of hours health services, which also dissuades doctors from taking on these responsibilities.

But before you get taken in by the press and click away, read below what one GP had to say about his experience of working out of hours:

A day in the life of an out of hours doctor

In a recent careers advice article on the BMJ website, Dr Zaid Al-Najjar shared his experiences of working as an out of hours GP. He explains that cases can range from the ‘benign to bizarre’ but that he gets to work with an invaluable team of colleagues. Different to a typical surgery day, out of hours stints tend to be more unpredictable, with no prior patient knowledge and can often mean more acute cases to deal with. Whilst he explains that doctors working out of hours are exposed to risks, the right preparation, being more vigilant and proper recording can go a long way, stating that the job ‘can be satisfying and a change from the management of more chronic conditions in daytime general practice’.

Calls for more out of hours doctors

With the government calling for GPs surgeries to be open 7 days a week, there is going to be further need for out of hours doctors to take on these duties. Last year, NHS England ran a pilot scheme which aimed to cover indemnity costs of doctors in a bid to break down recruitment barriers like the rising costs which was one of the reasons why doctors failed to take up these hours. Should NHS England follow the example set in Wales and other parts of the UK, they would be able to implement a risk-sharing system that would make GPs feel more comfortable in taking on out of hours roles.

For many doctors, working out of hours shifts is a rewarding and satisfying job – enabling them to help local communities and providing essential services to those who need them. A number of the risks associated with out of hours care could be mitigated through having more GPs sign up to work out of hours. Our East Berkshire Primary Care Out of Hours staff are a great team who work together to deliver services to local residents. You can read the latest feedback from past patients here as well as find out more about the work our out of hours care team do on our dedicated recruitment website.