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May 28, 2004 URGENT - We need your opinion

We are sure by now most of our GP members will have been consulted to some degree on their intentions with regard to Out of Hours care following the implementation of the new contract. The members of the BASICS Scotland Executive have put a lot of effort into monitoring what has been happening throughout Scotland over the past few months and the intentions of practitioners and Health Boards with regards to Out of Hours care. These enquiries have led us to believe that many GPs, including many of our own members, intend to opt-out of the provision of Out of Hours care. As a result of this we have observed that Health Boards are looking at the introduction of new systems of provision of Out of Hours cover which may significantly change the delivery of such cover by the end of 2004.

As a result of these changes we anticipate that by the end of 2004 many of our members will only be available to provide immediate care during normal working hours. If this were to be the case this would have very significant effect on both the philosophy of BASICS Scotland and the future viability of medically provided immediate care in Scotland. If members were only providing immediate for 40 hours per week we feel the following could well result.

• Such a level of provision would be of little use to the Ambulance Service and hence call out, which we are trying to improve at the present time, would be likely to cease.

• Health Boards and other organisations who presently provide funding for both equipment and education would cease to provide this funding.

We thus feel it is extremely important at the present time to consult our membership on their intentions with regards to providing Out of Hours care and the way forward for BASICS Scotland.

We do of course appreciate that many GPs in remote parts of the mainland and islands may not be intending, or have the option, to opt out of Out of Hours care, and hence for them things would remain as before. The numbers of GPs to whom this applies however is likely to be relatively small compared to the overall number of GPs in Scotland, and hence representation at national level may be difficult.

The future

Following discussion BASICS Scotland Executive recognise the following:

• The interests of remote mainland and island GPs will have to continue to be considered.

• A new breed of doctor who is actively involved in providing Out of Hours care may evolve and their needs will have to be considered.

• Many enthusiastic immediate care practitioners will no longer be involved in Out of Hours cover, and ways of maintaining their interest and enthusiasm have to be considered.

It is thus our intention to monitor on-going developments as closely as we can. To do this we have to have information from our members as to their intentions, and we would thus be extremely if the following questionnaire could be completed and returned to the BASICS Scotland office as quickly as possible. We will then try to represent our member’s interests by using the information collected to influence both at national and Health Board level the future funding of immediate care.

There are two issues on which we desperately need to know the feelings of our membership. The first of these is with regard to the future funding of immediate care. Many members will already be aware that immediate care as a national enhanced service in the new contract. The requirements for additional payments under this are fairly stringent and we doubt that many of our members would already have, or be willing, to undertake the training required to be eligible for such funding. We also doubt that such funding will be readily available from most Health Boards in Scotland. We would thus like the views of our membership as to whether or not we should push for this funding to be available, or whether we should continue with our current strategy which is to look for funding from the Health Service to provide educational activities to health professionals undertaking immediate care within Scotland and to encourage Health Boards to provide appropriate equipment for use by immediate care practitioners following appropriate training.

The second issue for which we require guidance is that of the future role of GPs who opt out of the provision of Out of Hours services. We appreciate that most people who opt out of Out of Hours services will remain committed and enthusiastic GPs and providers of immediate care. We would thus wish to know whether such members would be interested in a scheme where they carried bleeps in order that should a life threatening emergency, such as a cardiac arrest or serious road traffic accident occur in their area that the Ambulance Service could contact them to respond to appropriately triaged emergencies. There would not be a specific requirement to be on call for such emergencies.

With these ideas in mind we would be most grateful if you could complete the following questionnaire and also give us your views on any other areas to which we should be paying particular attention at the present time.

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