Accessing out-of-hours care following implementation of the GMS contract: an observational study

There is widespread concern that the quality of out-of-hours primary care for patients with complex needs may be at risk now that the new general medical services contract (GMS) has been implemented. To explore changes in the use of out-of-hours services around the time of implementation of the new...

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Bibliographic Details
Published in:British journal of general practice 2008-05, Vol.58 (550), p.331-338
Main Authors: Richards, Suzanne H, Winder, Rachel, Seamark, David, Seamark, Clare, Ewings, Paul, Barwick, Angela, Gilbert, James, Avery, Sarah, Human, Sarah, Campbell, John L
Format: Article
Language:English
Subjects:
Adolescent
Adult
After-Hours Care - organization & administration
After-Hours Care - standards
Aged
Cohort Studies
Female
Health Services Accessibility - organization & administration
Health Services Accessibility - standards
House Calls
Humans
Male
Middle Aged
Needs Assessment
Neoplasms - therapy
Original Papers
Outcome and Process Assessment (Health Care) - standards
Palliative Care
Risk Factors
State Medicine - organization & administration
State Medicine - standards
Triage
United Kingdom
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Summary:There is widespread concern that the quality of out-of-hours primary care for patients with complex needs may be at risk now that the new general medical services contract (GMS) has been implemented. To explore changes in the use of out-of-hours services around the time of implementation of the new contract for patients with complex needs, using patients with cancer as an example. Longitudinal observational study. Out-of-hours primary care provider covering Devon (adult population 900,000), UK. Two, 1-year periods corresponding to pre- (April 2003 to March 2004) and post-contract implementation (October 2004 to September 2005) were sampled. Call rates per 1000 of the adult population (age>or=16 years) were calculated for all calls (any cause) and cancer-related calls. Anonymised outcome and process measures data were extracted. Although overall call rates per 1000 population had increased by 26% (185 pre-contract to 233 post-contract), the proportion of cancer-related calls remained relatively constant (2.08% versus 1.96%). Around half (56%) of these callers had advanced cancer needs (including palliative care). By post-contract, the time taken to triage had significantly increased (P
ISSN:0960-1643
1478-5242
DOI:10.3399/bjgp08x280191