Out-of-hours service

Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.

Most Out-of-hours services in Scotland and Wales are provided directly by Health Boards. In Northern Ireland they are provided by the Health and Social Care Trusts. In England they are commissioned by Clinical Commissioning Groups, usually working together, as the contracts often cover large areas. Out-of-hours providers in England must be registered with, and are regulated by, the Care Quality Commission.

The contract for General medical services which most GPs work to requires practices to be responsible for their patients between 8 am and 6.30 pm from Monday to Friday. In some cities commercial deputising services were set up employing doctors to cover the out of hour’s period, paid by the practices in the area but these weren’t viable in much of the country.

Woodside Health Centre in Glasgow established a successful deputising service before 1973: “. . . twenty general practitioners group together to provide a highly organised system of out-of-hours health care … The telephone” (at the health centre) ” is permanently manned and the patients are not involved in the delays of a post office diversion system. In the evening the telephone is answered by an experienced registered general nurse who can give advice where it is appropriate. In the event of a visit being required the nurse is able to contact the doctor on duty by radiotelephone. . . . . The patient’s previous notes are readily available to the nurse in the health centre and can be passed on to the doctor on duty. . . . Control of the system is exercised by a sub-committee of the health centre committee of management. The system thus has the advantages of a commercial deputising service in allowing doctors to have adequate time off duty, but control is exercised from within the health centre.”

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Wikipedia