Abstract
Two inner city general practices in east London jointly provide care outside normal working hours without using deputising services for about 14,000 patients. The statistics on workload were reviewed for 1987 and 1988. An overall rate of face to face consultations of 4.1 per patient per year was recorded, there being 115,965 consultations over two years for a mean list size of 14,174 patients. Four per cent (4737) of such consultations were outside normal working hours. The annual rate of visiting outside normal hours was 128.1 per 1000 patients in 1987 (1793 visits) and 131.5 per 1000 in 1988 (1888 visits). The rates of night visiting were 18.8 (262 visits) and 18.9 (271 visits) per 1000 patients in 1987 and 1988 respectively. Only 24% of all the requests for medical help out of hours (1483/6220) were dealt with by advice given on the telephone. The high rates of consultation outside normal working hours with only a small proportion being dealt with on the telephone alone may be explained by indices of deprivation. Local rotas for out of hours work are a good compromise between meeting the needs of patients and doctors in deprived areas, but there are financial implications for inner cities.
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Selected References
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- Bosanquet N., Leese B. Family doctors and innovation in general practice. Br Med J (Clin Res Ed) 1988 Jun 4;296(6636):1576–1580. doi: 10.1136/bmj.296.6636.1576. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davison A. G., Hildrey A. C., Floyer M. A. Use and misuse of an accident and emergency department in the East End of London. J R Soc Med. 1983 Jan;76(1):37–40. [PMC free article] [PubMed] [Google Scholar]
- Hart J. T. The inverse care law. Lancet. 1971 Feb 27;1(7696):405–412. doi: 10.1016/s0140-6736(71)92410-x. [DOI] [PubMed] [Google Scholar]
- Hobday P. J. Night workload in one health district. Br Med J (Clin Res Ed) 1984 Sep 15;289(6446):663–664. doi: 10.1136/bmj.289.6446.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jarman B. Identification of underprivileged areas. Br Med J (Clin Res Ed) 1983 May 28;286(6379):1705–1709. doi: 10.1136/bmj.286.6379.1705. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lockstone D. R. Night calls in a group practice. J R Coll Gen Pract. 1976 Jan;26(162):68–71. [PMC free article] [PubMed] [Google Scholar]
- Marsh G. N., Horne R. A., Channing D. M. A study of telephone advice in managing out-of-hours calls. J R Coll Gen Pract. 1987 Jul;37(300):301–304. [PMC free article] [PubMed] [Google Scholar]
- Riddell J. A. Out-of-hours visits in a group practice. Br Med J. 1980 Jun 21;280(6230):1518–1519. doi: 10.1136/bmj.280.6230.1518. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Usherwood T. P., Kapasi M. A., Barber J. H. Wide variations in the night visiting rate. J R Coll Gen Pract. 1985 Aug;35(277):395–395. [PMC free article] [PubMed] [Google Scholar]