ABSTRACT
This chapter describes a framework for considering out-of-hours care based on the different settings for care and the different types of organisation which provide care. In order to consider the most appropriate way to provide out-of-hours general practice care, it is helpful to disentangle the characteristics of the providers of care from the different means in which care is delivered. Primary care centres may be simply an arrangement to open one local surgery outside normal hours, staffed by general practitioners (GP) working in an extended rota. The chapter discusses that GPs have provided telephone advice to out-of-hours callers, but the increasing importance of this form of care raises several issues. The first issue concerns the purpose of the consultation and the second question concerns the safety of telephone triage, particularly if patients expressly request a home visit. A deputising service can be defined as a commercial organisation which provides out-of-hours care on behalf of subscribing GPs.
