Table 2.
Summary of service users’ recommendations for out-of-hours (OOH) services
| Structure of services | Process of care |
| Accessibility | Communication |
| • Reduce waiting times for service response | • Provide information and updates on waiting times |
| • Provide more home visits | |
| • Extend opening times of local GP surgeries and pharmacies | Doctors |
| • Consider service users’ preference for receiving a local service | • Provide more information on illnesses, actions to take if symptoms worsen, repeat prescriptions, patient support groups and after care |
| • Provide transport for those otherwise unable to attend a treatment centre | |
| • Reduce the size of the area covered by an OOH service | |
| • Provide OOH pharmacies near to OOH treatment centres | • Listen to patients and understand what they say |
| • Provide a medication delivery service for patients otherwise unable to access medication | • Explain illnesses in simple terms |
| • Improve spoken English and comprehension | |
| • Ensure diagnosis or advice given is understood | |
| • Take more time with patients and never ‘rush the patient out’ | |
| • Demonstrate better understanding, care and respect towards patients | |
| Visiting patients | |
| • Provide free parking at OOH centres and emergency bells in remote OOH centre car parks | Address doctors’ refusal or reluctance to visit patients |
| • Access patients’ medical histories and medications | |
| • Employ more OOH doctors, general staff and specialist practitioners (especially dentists) | Consider patients’ individual circumstances and review indications for home visits for parents with young children, older patients, sole carers, disabled patients, patients too ill to travel, patients who would otherwise travel too far and patients without access to transport |
| • Employ OOH doctors at local hospitals and treatment centres currently without an OOH service | |
| Triaging patients | |
| • Consider more appointments to see an OOH doctor for service users receiving telephone advice | |
| • Eliminate question repetition within the triaging process | |
| • Re-examine the relevance of information sought within the triaging process for different circumstances | |
| • Ensure that receptionists do not give medical advice | |
| • Ensure that triage nurses and receptionists refer patients with symptoms that require emergency attention and pass on important information from patient to doctor immediately | |
| • Enable the patient to consult a doctor directly rather than another member staff, if requested |