ABSTRACT
This chapter reviews some of the themes and their likely impact on the future planning of out-of-hours general practice services. It considers the wider implications for primary care and describes one model of organisation which may offer a way forward. Just as patients’ expectations and behaviour may alter in response to their experience of new out-of-hours arrangements, so might the attitudes of general practitioners. The developments in out-of-hours primary care in the early 1990s were made possible by a number of contractual changes in general practice. These changes were introduced because of widespread resentment amongst general practitioners; with many doctors demanding to withdraw from providing out-of-hours work altogether. Although out-of-hours care represents only a small proportion of all primary care workload, it is the point at which the tensions between patients and professional expectations are felt most acutely. The chapter also presents some closing thoughts on the concepts covered in this book.
