VATHLT2070 | Doctors: Background to out-of-hours cover

Since 2013, responsibility for ensuring there is ‘out-of-hours’ cover lies with the Clinical Commissioning Group (CCG). Between 2004 and 2013, responsibility lay with the Primary Care Trust, and prior to 2004 it was the responsibility of the individual GP practice. In the main out of hours calls are channeled, in the first instance, to NHS Direct, although they could be outsourced to other service providers. Provision of this service is becoming increasingly fragmented.

In most cases, the call-centre staff are nurses who use computer-aided decision-making systems to determine the most appropriate course of action, which could range from calling an ambulance, asking the patient to make their own way to A&E, arranging for a doctor to call, or giving advice on self-care. They will resist referring to a doctor any calls that don’t require a doctor’s intervention. Accordingly, the service often involves triage assessment and signposting to other health services.