Since out-of-hours medical services were scrapped by local GP's surgeries the NHS 24/Direct service has tried to take up the slack. IN my estimation, it has failed in a number of ways.
1). The "nurse" on the end of the telephone has to triage the potential patient by making a snap assessment on the information provided and if either the questions script does not suit the aliment or the person trying to describe the problem is just not up to conscise communication over the phone, then many dangerous situations may - and in fact HAVE - slipped through the net.
2). The ordering of an ambulance out of hours has become a very hit-or-miss practice when it is the doctor in charge of the NHS 24/Direct line that has to give the final approval for this to happen. How many times have we heard in the media that either an ambulance was not ordered and patient died or the ambulance was so slow that the vital 1-hour safety period was passed before the patient got to hospital. Most people now know that that one "golden" hour is the period that may decide on whether a stroke or a heart attack victim will live or die !
3). Without the local knowledge of a patient's history ( which the doctor's surgery would have close to hand if not actually fresh in their minds ), the NHS 24/Direct service can often be making decisions based on incomplete data and serious lack of knowledge of the actual patient.
Nobody knows the patient better than the doctors and nurses of the local GP surgery and yet it seems that during out-of-hours times - or on bank holidays, as happened to me today - it seems that it is OK for a local surgery to just shut it's doors and to hell with the patients that depend on their skills.
Doctors used to share the night or weekend or late duty services but now they all just swan off to the golf course or wherever and seem able to put their patients out of their minds.
When one considers that GPs are paid a massive premium for working out-of-hours I was wondering why more of them are not available to do this these days ?
Opinions please ?
