Out-of-hours NHS acute services "inadequate"

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LONDON, Oct 29 (Reuters) More and more people are going to hospital emergency departments at weekends and in the evening because out-of-hours NHS care is inadequate, doctors said today.

The Royal College of Physicians called for radical improvements to reduce the strain on A&E departments and said diagnostic facilities such as blood tests and X-rays should be available around the clock.

''Out-of-hours care outside of hospitals is largely inadequate and inflexible, so patients go to hospitals because there is nowhere else for them to go to get the reassurance and care they need,'' the college said in a report.

Bryan Williams, Professor of Medicine at Leicester University, told BBC radio that changes to out-of-hours GP care and rising numbers of people coming to A&E was putting strains on hospitals.

He said ''safety first'' decisions by the junior doctors who often met patients at A&E meant that more patients with acute conditions were being admitted than was necessary.

Williams said the report called for improvements in care available in the community so that people with acute conditions did not always have to go to hospital for treatment.

It also called for more senior doctors to be available outside normal office hours covering acute services at hospitals.

This would allow patients to get ''a senior decision made on their condition, with the most appropriate pathway for their care, identified as soon as possible after presentation.'' Prime Minister Gordon Brown has promised to make it easier for patients to see family doctors in the evenings and at weekends, after changes to GP contracts which mean they are no longer responsible for patient care once their surgeries are closed.

Out-of-hours GP care is now organised by local primary care trusts, who contract out services to other GPs, cooperatives of doctors and private firms.

But Williams said the availability of diagnostic services also had to be improved, otherwise doctors attending patients in evenings or at night would still have to send them to hospital for routine diagnoses.

Health Minister Ben Bradshaw noted that out of hours care was also provided by telephone service NHS Direct and NHS walk-in-services.

''We have invested record amounts in out of hours services and patients are seeing the benefits -- eight out of 10 patients say that they are satisfied with the service, and six out of 10 rated the service as excellent or good,'' he said REUTERS SKB RK1544

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