John O'Malley's interesting editorial1 raises many good points and will, I hope, widen discussion about the entire provision of out-of-hours (OOH) care. I believe that the government in 2004 gave away too much in reducing the 24-hour commitment at a time when locally organised cooperatives were already providing excellent care in many areas, tailored to the needs of those areas and not a national blueprint. I write as a former principal in practice for nearly 30 years and one now working limited sessions in OOH.
OOH needs to be seen as a distinct sub-speciality of primary care requiring tailored training and appraisal programmes. This is of special importance at the outset of revalidation. ‘Audit’ (now an old fashioned word) is not really possible when the outcome of consultations and referrals is not available to the OOH doctor.
Footnotes
Member of the Faculty Board, West of Scotland Faculty RCGP. Sessional OOH doctor Forth Valley Health Board (these views are mine and not necessarily those of the above bodies).
- © British Journal of General Practice 2012