GP Out Of Hours Care: What Are The Risks?
There are a number of attractive benefits to GP out of hours care work, but there are also some risks that it is important GPs be aware of when engaging in this kind of work.
By understanding the risks and the steps that can be taken to mitigate them, it is perfectly possible for GPs to provide safe, appropriate care to patients while protecting themselves against any potential risks to themselves and their career.
The following are some of the key risks involved in GP out of hours care and steps we take at East Berkshire Primary Care Out of Hours Service to make sure those risks are minimised in practise.
Lack of medical history
One of the biggest issues facing GPs providing out of hours care is that there is usually a lack of background and medical history for the patients. This can make it much harder to correctly identify any ongoing conditions and presents issues for prescribing medication, as there is the risk of missing crucial information, such as allergies or potential interactions with other medication the patient may be taking.
It is therefore really important to get as much information from the patient as you can about their medical history while understanding that their recall may not be perfect and they may not always be totally forthcoming for a variety of reasons. You also need to give very clear instructions on what to do if the patient does not get better or gets worse.
Severity of patients’ conditions
Patients accessing out of hours care are often suffering from more acute illnesses and injuries because these are often the people who feel they cannot wait to make an appointment inside of surgery hours. This means the chances of a patient needing urgent care are higher, as are the risks of their condition taking a turn for the worse.
To minimise the potential risks here, you should make sure you quickly establish the severity of the patient’s medical condition and accurately record this information. This will allow you to assess whether they need referring for immediate care and also protects you in the event their condition worsens as you will have clear records to refer to.
It is also important to make sure you have appropriate medical indemnity insurance cover before taking on GP out of hours care work, as you will usually need additional cover on top of the medical indemnity insurance you have for working normal GP hours.
Medical indemnity insurance
Premiums for medical indemnity insurance covering out of hours work are normally significantly higher than those for standard GP work. This is due to the higher risks involved with treating patients with limited or no medical history and a higher percentage of serious conditions.
This extra cost can present an issue for some GPs considering out of hours care work, so make sure to find out what your premiums will be and all of your options for funding the extra cover. Schemes such as the free GP winter indemnity cover from NHS England are just one of the ways the NHS is seeking to offer additional support for GP medical indemnity costs.
Stress continues to be a major issue for doctors of all kinds and, if managed incorrectly, taking on additional out of hours work can add to this stress. Not only can out of hours GP work add to the number of hours you are working each week, it can also be inherently more stressful, due to the nature of the cases you deal with, as outlined above.
The answer is to make sure you are realistic about how much out of hours work you take on, to make sure you are not overloading yourself. You also need to make sure you are working with an out of hours care provider who supports you appropriately, something we at East Berkshire Primary Care Out of Hours Service take great pride in.
It’s also worth noting that GP out of hours care work can actually help manage your stress, by offering a more flexible alternative to working standard surgery hours, which often do not provide a good fit for those with other commitments, such as childcare.
Find GP out of hours care work that’s safe and flexible
East Berkshire Primary Care (EBPC) Out of Hours Service is a not-for-profit social enterprise supplying NHS services, including urgent out-of-hours medical care, for East Berkshire Clinical Commissioning Groups. Our service areas include Bracknell Forest, Slough, Windsor, Ascot and Maidenhead.
At EBPC, our goal is to provide first-class care for patients looking to see a GP outside of core surgery hours, as well as providing flexible out of hours work for GPs in a safe, supportive environment.
As well as allowing patients to see doctors at a time that suits them, we also offer our GPs the chance to work flexibly around their other commitments, meaning they can find a better work-life balance. A recent survey of our GPs found that 95% felt they were well supported by EBPC Management and the same percentage agreed they can provide the level of clinical care they would wish to work with us.
By providing a supportive environment for our GPs, we are able to mitigate the risks of GP out of hours care, both for doctors and patients. This means everyone can benefit from the availability of out of hours GP services with complete peace of mind.