Using and providing out-of-hours services: can patients and GPs agree?

Increasing demand for primary care outside the normal working week has come into conflict with the reluctance of doctors to continue to bear 'intolera ble' workloads and carry 24-h responsibility for their patients. These deve lopments have led to widespread changes in the organization of out-of-hours primary care. This paper provides new findings on differing perceptions of use of out-of-hours primary care (general medical) services in Great Brita in. By drawing on comparative data from an audit and research Increasing de mand for primary care outside the normal working week has come into conflic t with the reluctance of doctors to continue to bear 'intolerable' workload s and carry 24-h responsibility for their patients. These developments have led to widespread changes in the organization of out-of-hours primary care . This paper provides new findings on differing study on out-of-hours deman d involving 25 south-east London practices, the longitudinal perspective of patients and cross sectional perspective of GPs have been identified which can lead to miscommunication during a short out-of-hours consultation. In order to achieve more effective and efficient use and provision of out-of-h ours general medical services, a consensus must be developed over what emer gency primary care constitutes, and the provider perspective become more ac commodating in defining 'appropriate' use. Greater emphasis must also be pl aced on multidisciplinary working out-of-hours, to enable a more 'appropria te' response to the wide-ranging nature of demand for general medical servi ces.