Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
Items
Critical success
factors
Guidelines
Indicators (national
quality requirements
for after-hours
services)
time basis ass
freelance, locum or agency a doctors. GPs wwill
be responsible for clinical assessments and face-to-face conssultations.
Nurses:
As with GPs, nurses will be involve ed in clinical assessmments
and face-to-facee
consultations dependding
on their particular
skills and qualificatioons.
For example a nuurse
with experiennce
of working in a min nor injuries unit might see some patients, particularly
if the providder
has a base co-locaated
with a minor injurries
unit, but will probaably
not be used ffor
telephone triage. A nurse practitioner maay
be employed in eithher
role.
Emergency ccare
practitioners (ECP Ps):
Some organizations
use ECPs to conduct home visits for particular categoriies
of patients. Most EECPs
are ambulance clinicians or parameddics
with extended skkills.
There are usually
restrictions abou ut the type of patients tthat
an ECP can see.
Clinical lead:
Some servicees
will also have a clin nical lead covering a pparticular
area who can
be contacted if issuees
or problems arise, and can provide suppport
and advice on clinnical
matters. The clinical lead is usually y a GP or nurse with significant
after-hours eexperience.
Remark: Thee
specific skill mix of clinicians
varies betweeen
organizations with ssome
exclusively usinng
GPs while others haave
a greater proportioon
of nurses and ECPPs.
Logistic suppport:
Drivers are reesponsible
for driving clinicians to and fromm
home visits. They may
also have responssibilities
for stocking upp
on equipment and ccertain
medications in the
cars.
Overnight drivers
will often take the e role of receptionist inn
between home visitss.
Information aand
communication tec chnology: I
Information aand
communication tec chnology (ICT) supporrt
including electronic patient files and onlinee
connection to the GP
care
No informatioon
available.
No informatioon
available.
National Quaality
Requirements for after-hours services (ssince
January 1, 20055):
Providersf muust
report regularly to PCTs on their compliaance
with the Quality Requirements.
Providers muust
have systems in pl lace to support and enncourage
the regular exchange of up-to-date
and comprehensivee
information (includinng,
where appropriate,
an
anticipatory ccare
plan) between all a those who may be providing care to paatients
with predefinedd
needs (including, foor
example, patients wwith
terminal illness). GP
practices are encouraged to send any a special notes on ttheir
patients, e.g. for palliative care patientss,
to the relevant out-oof-
hours service. Thesse
notes will then be kkept
on the systemm
to assist clinicians and a call handlers with pprioritising
calls.
Providers muust
regularly audit a ra andom sample of patieent
contacts and apprropriate
action will be taken on the results oof
those audits. Regulaar
reports of these auudits
will be made available to the contr racting PCT. The sammple
must be defined in
such a way that it wwill
provide sufficient ddata
to review the clinnical
performance of eeach
f
A provider is anyy
organization providing
after-hours se ervices
Affter-Hours
Primaary
Care
Results
Providers muust
send details of all after-hours consultations
(including approppriate
clinical information)
to the practice where
the patient is reggistered
by 8.00 a.m. the
next working day. Where more tha an one organization is involved in the provission
of after-hours serrvices,
there must be cclearly
agreed responnsibilities
in respect of the
transmission of patient data.
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