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involved in the delays of a post office diversion system. In the evening the telephone is answered by an experienced registered general nurse who can give advice where it is appropriate. In the event of a visit being required the nurse is able to contact the doctor on duty by radiotelephone. . . . . The patient’s previous notes are readily available to the nurse in the health centre and can be passed on to the doctor on duty. . . . Control of the system is exercised by a sub-committee of the health centre committee of management. The system thus has the advantages of a commercial deputising service in allowing doctors to have adequate time off duty, but control is exercised from within the health centre.”
22:
248:
In April 2015 Exeter
Medical School used data from the official GP patient survey in England to score different types of providers out of 100. On speed, confidence and overall experience, scores from patients seen by commercial providers were lower. The score out of 100 for overall experience was 73
223:
introduced plans to enable "hard working people ...to see their GP seven days a week and out of office hours" in
September 2013. This promised access to GPs from 8am-8pm, and on Saturday and Sunday and to "test a variety of forward-thinking services to suit modern lifestyles, including greater use of
1295:
228:
on behalf of NHS England showed that extending opening hours and weekend opening were not a high priority for many patients. Long waits for appointments and failing to see a preferred, named doctor were more pressing issues. There was variation in demand for weekend opening with the highest demand
134:
which most GPs work to requires practices to be responsible for their patients between 8 am and 6.30 pm from Monday to Friday. In some cities commercial deputising services were set up employing doctors to cover the out of hour’s period, paid by the practices in the area but these weren’t viable in
163:
published by the
Department of Health in 2000 proposed quality standards which would apply not only to deputising services and Out-Of-Hours cooperatives but also to individual GPs & practices providing their own cover. Carson's proposal for “A new model of integrated out-of-hours provision ...
151:
in 1979 reported that commercially organised deputising services had grown rapidly over the last ten years and about one third of all GPs made some use of them. They received complaints that deputies lacked personal knowledge of the patient and access to the medical records, contacting the service
197:
services. According to John
Horrocks, chief executive of Urgent Health UK, "It's not the same as it used to be, where everyone took their turn in a co-operative. It's more of a lifestyle choice. Now, you often find GPs who specialise in out-of-hours … typically, a shift rota is available on the
143:
Woodside Health Centre in
Glasgow established a successful deputising service before 1973: “. . . twenty general practitioners group together to provide a highly organised system of out-of-hours health care … The telephone” (at the health centre) ”is permanently staffed and the patients are not
692:
is a federation of Social
Enterprise Unscheduled Primary Care Providers to which many of these organisations belong. According them in 2018 social enterprises were delivering out of hours services to 67% of patients in England, with an annual contract value of ÂŁ294 million. Since 2008 the
155:
In 1994 after minor changes to the GP contract many groups of doctors got together and formed cooperative organisations sharing the out of hours calls between a large number of GPs on a rota basis. A minimum of about 40 GPs were needed to set up a successful cooperative. In 1996 the G-Docs
693:
proportion delivered by NHS organisations has declined from 30% to 18% and that delivered by commercial providers dropped from 30% to 15%. Average annual funding per patient for social enterprise contracts is ÂŁ7.62, for NHS organisations ÂŁ8.10 and commercial organisations ÂŁ8.22.
306:
provided out of hours services in Mid Essex, Dudley, Sandwell, Heart of
Birmingham, South Birmingham, Wolverhampton, Herefordshire, Scarborough, Sunderland in England and Abertawe Bro Morgannwg and Carmarthenshire in Wales but withdrew from its contracts in November 2018.
171:
Until the 2004 contract most GPs provided care for their patients outside those hours either themselves, or as part of a GP Co-operative. The total amount earmarked for Out of Hours duties including Night Visit Fees was an average of just under ÂŁ6000 per GP per year.
205:
in July 2014 of people in
England found that the urgent care system is complex and many people do not know how to contact out-of-hours GP services or even that such services exist; that 26% had not heard of out-of-hours GP services, and 19% had not heard of
285:. It was taken over by Harmoni. Care UK Clinical Services Limited now provides unscheduled care to over 15m patients. It runs out of hours services in Rotherham, Hampshire, Harrow, Hillingdon, Merton, Islington, Kingston, Wandsworth, Camden and Ealing.
712:
reported that 10 of 104 providers who responded to a
Freedom of Information request admitted that there had been overnight and weekend shifts over the past year with no GP cover. The biggest number of sessions were in Peterborough and Tower Hamlets.
192:
both of which have been the subject of major complaints and of failing to employ sufficient doctors. By 2013 most of the co-operatives had converted to social enterprises. Many of the co-ops were involved in the provision of contracts to deliver
164:
accessed by patients via a single telephone call, routed in the first place through NHS Direct and passed, where necessary, to the appropriate provider of out-of-hours services in that locality.” eventually developed into
184:. Practices could opt out of the provision of out-of-hours services and lose the ÂŁ6000 and most did. Some PCTs worked with the GP co-operatives, but some gave the contract to a commercial provider, commonly
1229:
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for NHS providers; 72 for not-for profit providers; 69 for the commercial sector. Prof John
Campbell said the research showed that the poorest scores by providers were seen in the commercial sector.
872:
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are an example of a remote area where new models of care are being trialled, with Community Unscheduled Care Nurses being deployed for patients who need to be visited at their place of residence.
44:
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out-of-hours cooperative in Grampian became Scotland’s first out-of-hours general practitioner service, financed by 200 GPs who each paid a monthly subscription.
1317:
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123:, usually working together, as the contracts often cover large areas. Out-of-hours providers in England must be registered with, and are regulated by, the
1024:
119:
are provided directly by Health Boards. In Northern Ireland they are provided by the Health and Social Care Trusts. In England they are commissioned by
434:
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in Windsor, Ascot and Maidenhead where some 28.1% of patients wanted surgeries open on Saturday but it was lowest in Wigan, where only 13.9% did.
257:
Harmoni HS Ltd was a major provider of primary care, including out-of-hours services, which started as a GP co-operative and is now owned by
1251:
879:
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Skype, email and phone consultations for those who would find it easier." Results from the GP Patient Survey, an independent poll run by
1406:
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The new contract passed the responsibility for organising out-of-hours services from individual doctors to the
1274:"Gloucestershire's out-of-hours GP service is neither safe, effective, responsive nor well-led, report says"
663:
401:
318:
120:
680:
659:
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321:, reached agreement with the firm to end the current contract at the end of May 2015 – 17 months early.
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Central Nottinghamshire Clinical Services was placed in Special Measures after an inspection by the
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provide a nationwide commercial GP service that runs out of hours, weekends and bank holidays.
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IC24 provides services in East Sussex, Brighton & Hove, Kent, East Surrey and West Sussex.
40:
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Urgent Health UK- federation of Social Enterprise Unscheduled Primary Care Providers
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Provision of out-of-hours services is a particular problem in remote locations. The
709:
485:
278:
509:: HUC, Hertfordshire, Cambridgeshire & Peterborough, Luton & Bedfordshire
1073:"GP surgery hours: Fewer than 1-in-10 want Sunday opening in Greater Manchester"
160:
1230:"GP co-op takes over out-of-hours for 300,000 patients after provider collapse"
274:
266:
101:
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had been closed 50 times since December 2018 as no GPs were prepared to work.
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internet and the GP is able to sign up to whatever shifts they want to work."
1400:
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590:: Waltham Forest, Barking & Dagenham, Redbridge, Havering and West Essex,
262:
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214:
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could be difficult, and that deputies were slow in responding to emergencies
360:
1182:
974:"Department of Health and NHS England: Out-of-hours GP services in England"
950:
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provides services in central London on a commercial basis outside the NHS.
112:
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90:
689:
337:
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495:
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873:"Raising standards for patients: new partnerships in out-of-hours care"
350:
Birmingham & District General Practitioner Emergency Rooms (BADGER)
225:
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and Malling Health (UK) Limited (Walsall, Herefordshire, and Sandwell)
523:
116:
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external links, and converting useful links where appropriate into
240:
and that it could jeopardise the safety of Out-of-hours services.
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and sometimes if the practice is closed for educational sessions.
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946:"GP co-operatives mutate into out-of-hours social enterprises"
645:
349:
1362:"Vale GP unit closed 50 times since December, figures reveal"
398:
310:
189:
1139:"Enfield Clinical Commissioning Group appoints new chairman"
471:
440:
417:
389:
1095:"Concern over NHS 111 as CQC praises GP out-of-hours care"
604:
1047:"Seven day, 8am – 8pm, GP access for hard working people"
610:
587:
566:
554:
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East Berkshire Primary Care Out Of Hours Services Limited
412:
343:
104:
this is normally between 6.30pm and 8am, at weekends, at
1318:"Social enterprises now dominate GP out of hours sector"
460:
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and influenced the formulation of the 2004 GP contract.
1025:"NHS out of hours service to be tested in North Harris"
878:. Department of Health. 31 October 2000. Archived from
588:
Partnership of East London Co-operatives (PELC) Limited
506:
555:
London Central and West Unscheduled Care Collaborative
413:
City & Hackney Urgent Healthcare Social Enterprise
1340:"One in ten areas left without GP out-of-hours cover"
845:"Out-of-hours GP service to replace Saturday surgery"
384:
Bridgewater Community Healthcare NHS Foundation Trust
138:
1296:"Out of hours service first to be rated outstanding"
620:
South Western Ambulance Service NHS Foundation Trust
1252:"New solution sought for out-of-hours GP service"
716:In June 2019 it was reported that the service at
443:- rated outstanding following inspection by the
435:County Durham and Darlington NHS Foundation Trust
35:may not follow Knowledge's policies or guidelines
1398:
1208:"Out-of-hours GP service holds consultation day"
666:, North Tyneside, Newcastle and South Tyneside,
605:South East London Doctors' Co-operative (SELDOC)
557:: Westminster, Ealing, Hounslow, and Hammersmith
520:: Pembrokeshire, Ceredigion, and Carmarthenshire
1161:"Care UK buys largest GP out-of-hours provider"
313:had a contract to run out-of-hours services in
921:"The True History of GP Out of Hours Services"
761:"The True History of GP Out of Hours Services"
1392:The True History of GP Out of Hours Services
1141:. North London Newspapers. 10 September 2014
545:KCW Co-operative: Kensington & Chelsea
89:are the arrangements to provide access to
1254:. Western Morning News. 16 September 2014
1075:. Manchester Evening News. 1 October 2014
1053:. Prime Minister's Office. 1 October 2013
658:(formerly Northern Doctors Urgent Care):
607:: Sutton, Lambeth, Southwark and Lewisham
399:Central Nottinghamshire Clinical Services
71:Learn how and when to remove this message
672:Western Cheshire GP Out of Hours Service
472:East Lancashire Medical Services Limited
232:In October 2014 GPs complained that the
1298:. Health Service Journal. 13 April 2017
1183:"Out of Hours Primary Medical Services"
567:NEMS Community Benefit Services Limited
363:: Barnet, Enfield, Haringey & Brent
252:
1399:
1117:"Private GP out-of-hours care 'worse'"
1027:. Stornoway Gazette. 24 September 2014
1005:. Health Service Journal. 11 July 2014
895:
344:Not for profit and NHS trust providers
336:Services including Now Healthcare and
236:service had not been inspected by the
1320:. Health Service Journal. 8 June 2018
1210:. Salisbury Journal. 9 September 2014
813:Royal Commission on the NHS Chapter 7
635:South Essex Emergency Doctors Service
333:runs the service in Gloucestershire.
175:
1276:. Gloucestershire Live. 4 April 2022
918:
738:"GP and other Out-of-Hours services"
513:Humber Teaching NHS Foundation Trust
15:
898:"A quick guide to GP co-operatives"
13:
1003:"Many unaware of out-of-hours GPs"
594:Salford Royal NHS Foundation Trust
139:The GP Co-operatives prior to 2004
14:
1423:
1407:Private providers of NHS services
1380:
1364:. The Lochside Press. 15 May 2019
629:Staffordshire Doctors Urgent Care
518:Hywel Dda GP Out of Hours Service
502:Hampshire Doctors on Call Service
480:East of England Ambulance Service
304:Nestor Primecare Services Limited
758:
418:City Health Care Partnership CIC
300:provides services in Wiltshire.
20:
1354:
1332:
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1200:
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1153:
1131:
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599:South Central Ambulance Service
325:Zafash Medical Services Limited
938:
912:
889:
865:
837:
804:
778:
752:
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265:had contracts for services in
111:Most Out-of-hours services in
1:
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685:Yorkshire Doctors Urgent Care
294:provides services in Croydon
243:
121:Clinical Commissioning Groups
790:Socialist Health Association
319:Clinical commissioning group
7:
1097:. GP Online. 3 October 2014
896:Girach, Mo (26 July 2012).
681:Yorkshire Ambulance Service
551:(West Yorkshire and Craven)
379:Bolton NHS Foundation Trust
149:Royal Commission on the NHS
10:
1428:
919:Rose, Eric (10 May 2013).
786:"General Medical Services"
676:Wirral Community NHS Trust
524:Integrated Care 24 Limited
441:Cumbria Health on Call Ltd
1342:. Pulse. 3 February 2017
1232:. Pulse. 3 December 2018
1163:. Pulse. 6 November 2012
451:Derbyshire Health United
430:Derbyshire Health United
132:General medical services
703:Care Quality Commission
526:: Brighton & Hove,
467:East Cheshire NHS Trust
445:Care Quality Commission
424:Core Care Links Limited
238:Care Quality Commission
125:Care Quality Commission
1119:. BBC News. 1 May 2015
718:Vale of Leven Hospital
646:Urgent Care 24 Limited
573:Newham GP Co-operative
563:Stockport and Trafford
498:: Greenwich and Bexley
367:Barts Health NHS Trust
361:Barndoc Healthcare Ltd
981:National Audit Office
652:, Halton and Knowsley
203:National Audit Office
135:much of the country.
87:Out-of-hours services
373:Beacon Health Centre
317:but NHS Kernow, the
253:Commercial providers
95:General Practitioner
41:improve this article
954:. 20 September 2013
816:. HMSO. July 1979.
420:: Hull and Knowsley
404:and Nottinghamshire
357:: Bury and Rochdale
331:Practice Plus Group
182:primary care trusts
100:are closed; in the
53:footnote references
983:. 9 September 2014
885:on 7 January 2013.
490:Manchester, Oldham
482:NHS Trust: Norfolk
176:Changes after 2004
708:In February 2017
640:Taurus Healthcare
549:Local Care Direct
130:The contract for
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