Out-of-hours medical cover in community hospitals: implications for palliative care

Background The new General Medical Services contract in England means many GPs have transferred out-of hours work to their primary care organization, with implications for continuity of palliative care in community hospitals. Aim To examine existing arrangements for out-of-hours medical cover in community hospitals, focusing on palliative care. Methods Telephone survey of community hospital managers/senior nurses across England and Wales. Results Interviews (n = 62) revealed nursing staff were satisfied with existing out-of-hours care. Concern was expressed about the future of out-of-hours medical care from GPs as new services will cover larger areas, meaning unknown doctors may attend, taking longer to arrive. Conclusion Arrangements for out-of-hours medical cover in community hospitals are in transition, threatening the continuity of care for dying patients.