NorthEast DOC GP out of hours service

The NEDOC service has been in place for ten years and is provided by GPs with appropriate supports from the HSE. In 2010, a National Review of GP out of hours was completed and adopted by the HSE and the Department of Health.

Under the GMS contract, GPs have a responsibility to provide 24/7 cover. It is a matter for the GPs how they provide this cover and NEDOC has facilitated a pooling of resources and rota since September 2000. GPs put in place a revised rota from March 2011 which included a GP in each of four treatment centres during core hours and a number of GPs available with cars to attend home visits. Since March there has been four GPs available on the red eye shift (11:00pm to 8:00am seven nights per week). NEDOC Ltd. have indicated that they intend to reduce red eye cover to three GPs with effect from July. They also indicated they intend to reduce some core hours during the summer months and these will be available during the busier winter period. The HSE are awaiting the proposed revised rota from NEDOC Ltd. and will evaluate this against activity.

There has been a change in payment from 1st March, 2011. GPs are receiving €45 per medical card patients treated between 6:00pm and 8:00am and weekends. The STC payment system has been in place in all co-ops with the exception of NEDOC and DDOC since their inception. Heretofore, GPs were in receipt of an annual grant for provision of GP out of hours services.

Since the implementation of the new payment system in March 2011, GPs can claim an STC for urgent patients seen 8:00am – 9:00am and 5:00pm – 6:00pm in their own surgeries and any exceptional presentations to them at their surgery location out of hours. This facility was not available to them prior to March 2011.

NEDOC is an urgent GP service – it is not a routine service for medical conditions that can wait until the GP surgery re-opens nor is it an emergency service. The HSE are continuing to provide the equipped and staffed treatment centres for the NEDOC service, including nurses, receptionists and drivers and cars for home visits. The GP out of hours co-ops nationally have enabled GPs to participate in rotas to fulfill their out of hours responsibility on a pooled basis.

The National Review recommended all co-ops move to a nurse triage system. This recommendation was implemented in the NE in March 2011. Trained nurses provide the triage service supported by computer assisted decision making software. GPs retain private fees.

The HSE recognizes that the members of the public need clarity in relation to availability of GP out of hours services. The HSE had informed GPs in mid 2010 in relation to the new funding method, implemented on 1st March.