ABSTRACT
This chapter describes some of the main themes and dilemmas in out-of-hours care which are common internationally. An important feature of any healthcare system is its ability to respond appropriately and quickly when faced with urgent needs for assessment, advice and treatment. From a professional viewpoint, services are required 24 hours a day to diagnose and treat illnesses and injuries which threaten life or limb or carry a high risk of lasting harm without immediate attention. In the United Kingdom, general practitioners are personally responsible for ensuring that their registered patients have access to primary medical care 24 hours a day, seven days a week. Health centre waiting rooms are crowded throughout the evenings and weekends, with patients using the out-of-hours service as a convenient alternative to daytime consulting. Since opening is mandatory, there is little incentive to organise daytime services more efficiently to reduce out-of-hours workload.
