ABSTRACT
This chapter presents that key issues relating to the quality of out-of-hours services. These include identifying and understanding needs and demand, the availability and accessibility of services, the reliability and consistency of care, organisational and professional interfaces and patient acceptability. Out-of-hours services have suffered from considerable variations in the quality and delivery of care. Achieving quality in out-of-hours services involves managing the tension between demand, needs and resources. Quality has gained great emphasis in the agenda for the new National Health Service (NHS). Clinical governance will bring greater accountability to each part of the NHS and all healthcare professionals will be involved. Quality improvement needs to be an ongoing process and audit; professional development and other components of organisational learning are all important components. Quality improvement needs to occur in the context of the whole urgent-care system. Out-of-hours care involves a multiplicity of interfaces between different health service organisations, professional groups and within-hours services.
