The BMJ recently held a discussion between experts in the fields of general practice, emergency medicine, and paediatrics about the state of out of hours care in the UK, and crucially offered their vision for a better service.
Are children a special case, can urgent care â€˜hubsâ€™ be a silver bullet, is NHS 111 up to the job of triaging patients, do there enough clinicians involved in out of hours care, and are other countries doing a better job?
The state of out of hours care can best be described as â€˜patchy,â€™ with some, even most, people receiving good and timely care although from a confusing plethora of different bodies - walk-in centres, urgent care centres, out of hours centres, telephone consultation and - that most recognisable of all NHS brands - Accident and Emergency. But there are also very serious deficiencies attributed to core problems identified by our experts below.
Around the table were: Clifford Mann, president of The Royal College of Emergency Medicine and an emergency medicine consultant in Taunton in Somerset; Neena Modi, professor of Neonatal Medicine in the Imperial College, London and president of Royal College of Paediatrics and Child Health; and Professor Martin Roland, professor of Health Service Research at the University of Cambridge and who has 35 years experience as a GP.
Read the write up:
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