TY - JOUR T1 - January Focus JF - British Journal of General Practice JO - Br J Gen Pract SP - 2 LP - 2 DO - 10.3399/bjgp09X394761 VL - 59 IS - 558 AU - David Jewell Y1 - 2009/01/01 UR - http://bjgp.org/content/59/558/2.abstract N2 - GPs in the UK relinquished responsibility for managing out-of-hours care in 2004, and since then there has been a rumbling undertone about the quality provided. Years ago, when I was completing my training as a junior, the responsibility for night work was pretty clear. The GPs covered their own practices at night, and most of the work in hospitals was done by the junior doctors — some of them with several years' experience, and many of them of excellent judgement, but juniors nevertheless. Then the whole role of juniors changed, with fewer of them around, and their hours of work more tightly controlled. At the same time the plan was that consultants, the doctors with most expertise, should be more personally involved out-of-hours, as has happened. But look: in the same period exactly the opposite change has taken place in primary care. Now those … ER -