National Review of GP Out of Hours Service - Health Service ...

11. Recommendations
No. Topic Recommendation
11.1 Treatment Centres There are 75 treatment centres (+ 4 extended hours’ centres) nationally in
addition to a number of part‐time centres in particular areas. It is
recommended that each RDO examine this provision with regard to
location and easy access to services for the patient.
11.2 Call Centres
11.3 Payments to GPs
11.4 GP Income from
non­GMS Patients
11.5 Standard Service
Level Agreement
11.6 DDoc/Caredoc
Nurse
TelephoneTriage
Agreement
11.7 GP/Nurse
Telephone Triage
11.8 Drivers in
Cooperatives
11.9 National Drugs
Stock List
There are currently 7 call centres. It is recommended that there should be
four call centres nationally. The Review Group proposes consideration be
given to the following construct:
• Ardee Call Centre to cover the former North East and the former
Midlands area.
• DDoc to cover the former ERHA area including KDoc.
• The South and the West to have one call centre each – to be
determined by the RDO.
All future payments to GPs should be on the basis of STC claims that
would be submitted online via the call management system, to the PCRS.
This process will facilitate a full audit trail of payments to GPs and the
cessation of any parallel claims.
In determining the future grants paid by the HSE to cooperatives,
cognisance needs to be taken of the private income generated by GPs’
attendance on non‐GMS patients.
The HSE’s national service level agreement template is required to be
applied to all organisations that are in receipt of grant payments from the
HSE including GP cooperatives. The Review Group has reassessed the
national service level agreement with a view to its application to GP
cooperatives (appendix 9) The service level
agreement will give a
standard approach to:
• Roles and Responsibilities
• Information requirements
• Governance arrangements
• Complaints
• Risk Management
• Quality and Standards
• Clinical Governance and Audit
It is necessary to review the DDoc/Caredoc nurse triage agreement to
facilitate bringing the costs in line with nurse telephone triage nationally.
The Review Group acknowledge the merits of GP telephone triage as
operated in NeDoc. However, in the interests of cost effectiveness and
quality assurance, the Review Group recommends that nurse telephone
triage, only, be undertaken nationally. Should a cooperative wish to
continue with GP telephone triage it should only do so at nurse telephone
triage payment rates. Nurse telephone triage is supported on the basis
that it can be quality assured through the nurse telephone triage clinical
decision support system; it is cost effective and provides standardisation
to the triage process nationally.
The Review Group recognises the necessity for drivers in the
cooperatives; however each region should review the delivery of services
by the drivers with a view to providing services in a more cost effective
manner, particularly with regard to the ‘red‐eye’ shift.
Drugs prescribed through the out of hours’ service should be standardised
through the application of a national GP Out of Hours’ Drugs Stock List.
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