Summary of management and follow-up options received for cancer-related calls at baseline and follow-up.
| Time period | ||||||
|---|---|---|---|---|---|---|
| Pre-contract, n (%) | Post-contract, n (%) | Absolute risk difference (post–pre), % | Relative risk (95% CI) | χ2 | P-value | |
| Management option received | ||||||
| Patient receives telephone advice | 1247 (36.3) | 1757 (42.4) | 6.1 | 1.17 (1.10 to 1.24) | 29.2 | <0.001 |
| Patient offered a treatment centre appointment | 304 (8.9) | 454 (11.0) | 2.1 | 1.24 (1.08 to 1.42) | 9.3 | 0.002 |
| Patient receives a home visit | 1431 (41.7) | 1659 (40.1) | −1.6 | 0.96 (0.91 to 1.01) | 2.0 | 0.150 |
| Patient cancels call | 68 (2.0) | 91 (2.2) | 0.2 | 1.11 (0.81 to 1.51) | 0.4 | 0.510 |
| Patient referred direct to hospitala | 12 (0.3) | 46 (1.1) | 0.8 | 3.18 (1.69 to 5.99) | 14.3 | <0.001 |
| Patient triaged, then passed to an in-hours serviceb | 371 (10.8) | 134 (3.2) | −7.6 | 0.30 (0.25 to 0.36) | 172.9 | <0.001 |
| Post-consultation follow-up and/or recommendations | ||||||
| Clinician organises patient admission to hospitalc | 385 (11.2) | 499 (12.1) | 0.8 | 1.07 (0.95 to 1.22) | 1.3 | 0.260 |
| Patient died or death is expected | 123 (3.6) | 187 (4.5) | 0.9 | 1.26 (1.01 to 1.58) | 4.2 | 0.040 |
| Patient may need/or have been re-visited by OOH clinician | 12 (0.3) | 77 (1.9) | 1.5 | 5.32 (2.90 to 9.76) | 36.9 | <0.001 |
| OOH clinician issues a special message to in-hours team | 212 (6.2) | 126 (3.0) | −3.1 | 0.49 (0.40 to 0.61) | 43.2 | <0.001 |
| Patient referred back to in-hours GP for follow-up | 73 (2.1) | 536 (12.9) | 10.8 | 6.09 (4.79 to 7.74) | 297.0 | <0.001 |
| Patient definitively managed during the OOH consultation | 2628 (76.6) | 2716 (65.6) | −11.0 | 0.86 (0.83 to 0.88) | 108.6 | <0.001 |
OOH = out-of-hours.
↵a Given the small numbers receiving the management options of ‘call handler calls ambulance for patient’, or ‘patient triaged and referred direct to hospital’, for analysis purposes these categories have been collapsed into ‘patient referred direct to hospital’.
↵b This category is used when the out-of-hours clinician determines that the caller's needs are more appropriately met through consultation with another in-hours service (for example, community nursing team) but not their GP.
↵c This category was used in combination with the management outcome category of ‘patient referred direct to hospital’ for 42/385 calls (10.9%) during the pre-contract period and 54/499 calls (10.8%) post-contract. For all other calls this follow-up option was used in combination with the management options of home visit (pre-contract 229/385, 59.5% versus post-contract 247/499, 49.5%), treatment centre (45/385, 11.7% versus 86/499, 17.2%), or telephone advice (69/385, 17.9% versus 109/499, 21.8%).