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

• DOI: 10.3399/bjgp08x280191
• Publication Date: 2008-04-30T01:54:11Z
• Authors: Suzanne H Richards; Rachel Winder; David Seamark; Clare Seamark; Paul Ewings; Angela Barwick; James Gilbert; Sarah Avery; Sarah Human; John L Campbell
• Keywords: Triage

There is widespread concern that the quality of out-of-hours primary care for patients with complex needs may be at risk now new general medical services contract (GMS) has been implemented.To explore changes in use around time implementation needs, using cancer as an example.Longitudinal observational study.Out-of-hours provider covering Devon (adult population 900,000), UK.Two, 1-year periods corresponding to pre- (April 2003 March 2004) and post-contract (October 2004 September 2005) were sampled. Call rates per 1000 adult (age>or=16 years) calculated all calls (any cause) cancer-related calls. Anonymised outcome process measures data extracted.Although overall call had increased by 26% (185 pre-contract 233 post-contract), proportion remained relatively constant (2.08% versus 1.96%). Around half (56%) these callers advanced (including palliative care). By post-contract, taken triage significantly (P<0.001). Although proportions admitted hospital or receiving a home visit constant, where special message was sent clinician in-hours team decreased (P<0.001).The demand did not alter disproportionately after contract. While potential indicators (for example, admissions, visiting rates) potentially adverse communication between clinicians observed. Quality standards databases require further refinement capture elements relevant needs.