There is an out of hours (OOH) GP service - paid for, and commissioned by Ealing Clinical Commissioning Group ( ie the NHS) . Any GP practice will have the OOH number on their answerphone, and the 111 service is able to refer any patients to it.Unfortunately the current service is provided by the lowest cost provider. OOH care was originally providied by individual practices , but increasing demands led to the formation of GP cooperatives ( such as Harmoni) which provided an excellent service.The Labour government killed off Coos overnight with the 1990 contract, and a clinically led service became a private company overnight. The current OOH service is a shadow of what used to be available, so people tend to vote with their feet and go to A/E, with increSingly minor complaints.The 111 phone service seems to be almost unknown by the public - at least NHS Direct, a national service, employing over 1000 nurses , achieved 45% recognition. Alas, the NHS bean- counters decided that the 111 service, staffed by non- clinicians, and supported by software that was known to refer more people to a/E than that used by NHSD , was the way forward.1200 people were made redundant at a cost of £60 million when it was closed in June 2013.The NHSD website ( used. By 12m people a year for initial self care ) was also closed, and is only now being replaced.So it's no wonder that the NHS has OOH / A/e problems.It is also worth noting that the cipurrent generations of medical students will accumulate debts of £90k - a definite incentive not to enter general practice but to stay in specialities with good opportunities for Privare Practice.
Nick Robinson ● 4094d