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GP out-of-hours service in Wales floundering

RCGP launches five-step action plan

Adrian O'Dowd

Thursday, 02 August 2018

GP leaders in Wales have today launched a five-step action plan to try and turn around what they describe as an “unsustainable” out-of-hours service that is under serious strain.

The plan comes as BBC Wales released details of an investigation showing that Welsh health boards were unable to fill hundreds of out-of-hours shifts during the course of last winter.

The RCGP in Wales has published its action plan Meeting urgent needs: improving out of hours services in Wales, which calls on the Welsh government and local health boards to take five “essential and achievable steps” to turn around GP out-of-hours services care in Wales.

Launching the new action plan, RCGP Wales called for an increase in the number of call handlers to ensure patients could access the services they needed because long waits on the phone meant people were more likely to hang up and call 999 or to go A&E.

It also called for:

  • better use of a wider primary care team
  • better use of technology
  • clearer national guidance for those working in the services
  • measures to address the wider issues facing general practice.
The plan comes as the pressure facing out-of-hours services was increasingly clear, said the college, shown by reports from the Board and Community Health Councils* and the Wales Audit Office** published in May and July respectively, which had highlighted weaknesses.

The BBC Wales research, published today, detailed a “crisis” in GP out-of-hours services. Freedom of Information requests had shown many health boards missed key targets for meeting calls ranked as urgent in terms of home visits or appointments, and several health boards failing to provide any GP out-of-hours cover at all in their areas at various points in the six months to March 2018.

Dr Rebecca Payne, RCGP Wales chair, said: “Patients’ needs don’t stop when practices close, but evidence is mounting that accessing out-of-hours services is too difficult.

“GPs are going above and beyond to try and make things work, but the support to deliver services simply isn’t there and patients are feeling the effects.

“The recommendations in our plan are essential, but also achievable. We are not asking for the moon; call handlers should be relatively simple to recruit, they are trained to follow clinically developed pathways and increasing their number would deliver a clear benefit. Patients being unable to access services is a waste of their time and diverts demand to other areas of the health service.”

Wales needed out-of-hours services to reflect the modern nature of the primary care workforce, she added, while ensuring services were aided by technology that already existed.

“The recommendations outlined in our plan would lead to a real improvement in services. Welsh government and local health boards need to recognise the scale of the problem and implement these solutions as a matter of urgency.”

A Welsh government spokesperson said: “We expect health boards to provide care to meet the needs of patients out of hours, and make best use of all multi-disciplinary professionals.

“Whilst a recent Wales Audit Office patient survey revealed that 89% of respondents rated the service as excellent, or very good, we are working with health boards to improve out-of-hours services further.”

*The fragility of GP Out of Hours services in Wales. A report prepared by the Community Health Council, May 2018.
**Primary Care Out-of-Hours Services. A report prepared by Wales Audit Office, July 2018.

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