Out-Of-Hours Services

1 Introduction

For GPs, 'out-of-hours' services cover weekdays (Monday to Friday) from 7pm to 8am the next day; at weekends, from 7pm on Friday evening to 8am on the following Monday, and throughout bank and public holidays. Out-of-hours services are there for urgent medical treatment only - that is where a patient cannot reasonably wait until the next normal surgery session.

The out-of-hours services covered by our survey run from 6pm until 7 to 8.30am the next day, Monday to Friday (the time varies depending on the individual service). The services also run at weekends, from 6pm on Friday until 7 - 8.30am on Monday, and throughout bank and public holidays.

In 1996, the Eastern Health and Social Services Board provided extra resources which encouraged practices to form co-operatives to cover the out-of-hours commitments of member GPs. Within the EHSSB there are three GP co-operatives - Belfast Doctors- on-Call (BELDOC), South and East Belfast Out-of-Hours Service (SEBDOC), and North Down and Ards Doctors-on-Call Service (DALDOC). Each co-operative has its own call centre and transport for the GPs who are on-call. From late 2000, SEBDOC covers 27 GP practices, DALDOC covers 29 practices and BELDOC covers 22 practices.

The Contactors Bureau, set up in 1953, also provides an out-of-hours service within the Eastern Health and Social Services Board. It covers 42 GP practices in the Greater Belfast area, and employs GPs to provide an out-of-hours service to patients where the GPs from their own practices cannot always be available out-of-hours.

DALDOC, SEBDOC and BELDOC are all non-profit-making companies. The Contactors Bureau is a private company. Each company has a board of directors or an executive committee. Out-of-hours care provided by Contactors Bureau, DALDOC and SEBDOC is usually provided by GP principals (senior GPs), although each service also uses locum GPs (substitute doctors). The BELDOC service is provided by GP principals only.

The DALDOC service covers North Down, the Ards Peninsula, Newtownards, Comber, Lisbane, Ballygowan and Moneyrea to the outskirts of Dundonaid. The SEBDOC service covers South and East Belfast, and the Contactors Bureau service covers Belfast and Greater Belfast. The BELDOC service covers North and West Belfast. The furthest distances that patients would have to travel to reach an out-of- hours centre are five miles in the case of BELDOC, 15 miles in the case of SEBDOC, 23 miles in the case of DALDOC, and 20 miles in the case of the Contactors Bureau.

In relation to the size of the population served by the out-of-hours services, the Contactors Bureau serves approximately 202,725 people. DALDOC serves 148,000 registered patients, as well as people who have not registered with them. SEBDOC serves 122,500 people. BELDOC serves II 5,000 patients.