GPs will no longer have to provide out-of-hours care

A survey by Pulse magazine found more than six out of ten GPs fear the new arrangements will be less safe than existing out-of-hours cover.

Top concerns were that patients will receive inappropriate advice and medication.

Many also predicted a rise in the number of patients being sent to A & E.

GP concerns: Patients receiving inappropriate advice - 72% worried Poorer standards of care - 72% Patients receiving inappropriate medication - 62% Rise in A&E referrals - 92%

The Department of Health announced in November that overall spending on out-of-hours care was set to double to �92m a year to ensure that primary care organisations could cope with the changeover.

Targeted

Health Minister John Hutton said the extra money would go to those PCTs facing the biggest challenge in developing their out of hours services, such as those in rural or inner city areas.

But the Pulse survey, of 1,168 GPs, suggests that family doctors are still not convinced that about the new arrangements, which will begin to come into force from April.

Under the terms of the new GP contract, family doctors will no longer have to shoulder responsibility for their patients outside normal surgery hours.

Primary care trusts in England - and their equivalents in the rest of the UK - have until 31 December this year to organise the transfer of responsibilities.

However, nearly one third of GPs expected the change to take place before that date.

The survey found that 83% of GPs say they will pass responsibility for out of hours to their primary care organisation.

Pulse editor Phil Johnson said: "For many years GPs have been saying that the demands of modern general practice make 24-hour responsibility untenable, so it is no surprise that they are passing the responsibility back to primary care organisations.

"What is worrying is that GPs have so little faith in the ability of these organisations to deliver a safe level of cover - despite having had years in which to prepare."

BMA response

Dr Hamish Meldrum, deputy chairman of the British Medical Association's GP Committee, said doctors' leaders were working to ensure that contracts offered by primary care organisations to out-of-hours providers made it clear that any drop in standards of care would not be acceptable.

He said that although the majority of practices were set to opt out of out-of-hours care, there were still many GPs who would be involved in providing the service.

"I hope there won't be any seismic shift, and that the standard and quality of services will be maintained.

"After the whole point of the change is not only to make general practice more attractive to doctors, but to make the service safer for patients.

"If I was a lorry driver or an airline pilot I would not have been allowed to work some of the hours I have, but because I am a doctor then apparently it has been okay to work all day, and then part of the night too."

Health Minister John Hutton said: "Where GPs choose to hand over responsibility for out-of-hours care to their local PCT, patients will continue to be offered safe, fast and convenient care, delivered through nationally set quality standards.

"Only services meeting these high standards will be allowed to provide out-of-hours care."

Out-of-hours is defined as 6.30pm to 8am from Monday to Friday, plus weekends and bank holidays.