More and more nurses are being used to cover out-of-hours services since primary care trusts took over responsibility for their provision, according to reports.
And almost half of GPs questioned admitted they feel the service had got worse since the changes in 2004.
A survey by Pulse found that almost half of the 42 PCTs questioned now used nurses and emergency care practitioners for some face-to-face consultations. The figures rose to 65% for telephone contacts.
On average, nurses accounted for only 6% of face-to-face consultations. However, in Warwickshire PCT the figure rose to 30%, while in Western Cheshire PCT it was 25% and in Blackburn with Darwen PCT 21%.
In a separate survey of almost 600 GPs, 64% said their trust was cutting the number of shifts covered by GPs, and 69% said there were moves to replace on-call doctors with nurses and emergency care practitioners. As many as 71% of GPs said they did not support these moves.
Only 19% felt the service had got better since the changes. And only 58% said their own local out-of-hours service was of high quality.
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Are you covering out-of-hours services in your PCT? Do you think the OOH service has got worse since 2004? Your comments: (Terms and conditions apply)
"I have worked as a nurse practitioner in out of hours since 2004, having achieved a Masters in Primary Care. More and more nurses are being employed in this service, some with only the basic skill requirements. No wonder the quality of care is so varied and GPs are voicing their concerns. GPs have to mentor/back up all the nurses within each team – a daunting task for some as those nurses are not known to them at all." - June Rhodes, Derbyshire
"Yes I cover OOH for GPs. The comments on service improvement are vague – is it better for PCTs (ie, cheaper), patients (ie, more holistic), GPs (ie, able to have a social life) – what and who are we measuring here? However, I am incensed that if GPs pick up OOH again they will gt a big salary increase – what happened to a manageable public wages increase Darling???" - Kirsty Armstrong, Hants/London
"All I know is that when I was in agony last year in the middle of the night, the out-of-hours service refused to come to my home and expected me to drive 12 miles to their centre. I knew I had renal stones and had already been discharged from hospital but I had to ask my estranged husband to collect a prescription for me at 6am, which was the earliest the on-call doctor stated he would help, as he was driving to another centre near where I live. This was Trafford/Stockport." - Lynne Hayward, Manchester
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