THE general manager for the NHS Out of Hours Service has promised four GPs on duty after midnight are enough to cover Cornwall.

Kate Lock, the chief operating officer of Cornwall Health, was at Launceston Community Network Panel last week to talk about the GP out-of-hours service, which Cornwall Health took on in June. The former provider was Serco.

The out-of-hours service is in place evenings, Saturdays, Sundays and bank holidays, outside the ‘core hours’ a GP provides care for a patient from a local practice — which are between 8.30am to 6.30pm, Monday to Friday.

On being asked about the number of GPs who will be providing the service after midnight, Ms Lock said: “I promise you [four] is enough. It’s more than most counties have. Trust me, that’s enough. We have done the data and we know we can cover the county with that. The Clinical Commissioning Group is absolutely clear that’s an acceptable level of service.”

She said trial data from the summer months showed numbers of cases coming into the out-of-hours service were ‘absolutely flat’.

“Most people who come on holiday in Cornwall are young families and adults. If something goes wrong it’s usually an A&E problem.

“We found it absolutely flatline over the last three months. We are building our rota on the basis of those three months. I am quite confident we have got that right.”

She said all the GPs working in the out-of-hours service are working in Cornwall, not locum doctors, and would be based ‘along the spine’ of Cornwall. They can be driven to treatment centres or to treat people at home as appropriate.

Cllr John Conway, suggesting Launceston Hospital should be one of the bases, said: “Launceston is right in the centre. You only need to look at a map, that’s the quickest place to get to anywhere.”

Ms Lock said: “If you go into Launceston Hospital you can’t swing a cat. You can’t see patients in the waiting room. I made the decision along with my clinical colleagues that it wasn’t safe to have people waiting where nobody could see them.

“Whereas if you go to Liskeard Hospital the reception desk is right opposite the waiting area. I wasn’t going to put you guys through one patient helping out another patient because no one else can see them.”

Cllr Conway, referring to Launceston Medical Centre’s expansion plans, said the out-of-hours service could talk to the centre to see if there is any potential to run services from there.

Ms Lock said: “What none of us want is a situation where there is one GP and a critically ill patient and no one to help. But if you are based in a hospital other people are able to come in and help.”

Cornwall Health has produced leaflets about how to access out-of-hours care, which were circulated at the meeting, and Ms Lock also explained the process.

She said South Western Ambulance Service provides the 111 service — the first point of call for someone looking to receive care out-of-hours. This service determines whether a patient is then seen by a GP out-of-hours, is told to wait to see their GP the next day, or to attend an A&E department or minor injury unit.

Ms Lock said Cornwall Health is owned by the GPs of Cornwall and Devon Doctors, who she said are ‘providing a lot of support over the border’.

Ms Lock said there is a ‘lot of crticism of 111’, but said Cornwall Health ‘does not run’ the service. She was quizzed on the qualifications of those on the other end of the phone, and said: “Call advisers have two weeks training and use a computer algorithm to work out what you are saying. The others are very highly trained nurses.

She said the doctor would have all the information taken from the 111 operator, and will ‘almost always want to speak to you first to find out what’s going on’.

“The most likely thing to happen is that’s the end of your encounter with the GP. If you need a prescription they can fax it.

“We are finding about 60% of patients can get the care they want over the phone or a prescription faxed locally.

“If after that conversation a GP needs to see you he will arrange to see you.”

Cornwall has eleven treatment centres where GPs can see patients, including Launceston, Stratton, Liskeard and Bodmin. She said the wait to be seen at a treatment centre after going through the 111 service is usually within an hour.

“The essential thing is the GP will have a conversation with a patient to find out where the best place is to see that person.”

She added home visits do take place, but are usually for ‘very frail elderly people who can’t get out of their home’.