(The use of out of hours health services: a cross sectional survey)

British general practitioners' contracts give them 24 hour responsibility for their patients. The component of total remuneration related to out of hours work has never been made explicit and such work has increasingly been seen as an important source of stress and low morale among GPs. This has led to demands that pay for out of hours work should be explicitly stated and negotiated. In a study of out of hours health services in Buckinghamshire, published in this week's BMJ, Brogan et al found that the system of fees for night visits reimbursed only 39 per cent of the home visits performed by GPs out of hours and GPs were the largest provider of this service. In light of their findings the authors suggest that policy changes to cope with growing demand for out of hours care will require much more than changing GPs' contracts.

Contact:

Dr Catherine Brogan, Consultant in Public Health Medicine, Anglia and Oxford Regional Office NHS Executive, Linford Wood, Milton Keynes