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GP out-of-hours "crisis" in Wales.


The scale of the "crisis" facing GP out-of-hours services in Wales has been revealed by freedom of information requests by the BBC.

The information gathered by BBC Wales shows Welsh health boards could not fill hundreds of shifts, equating to thousands of hours of GP-cover during winter 2017-18.

The research showed many health boards missed, by a significant margin, key targets for meeting calls ranked as urgent in terms of home visits or appointments.

Several health boards failed to provide any GP out-of-hours cover at all in their areas at various points in the six months to March 2018.

In some instances, patients had to wait 24 hours or longer for a home visit or to get an appointment to see a GP at weekends or outside surgery hours.

Gwen Goddard from Cwmbran said that her bipolar disorder meant she often needed to access services during the night or at weekends.

She said: "I have been told to call back in the morning. I have been told to call the Samaritans.

"The impact is enormous. If you are in a mental health crisis, having a panic attack or are feeling suicidal and can't get hold of somebody, or have to wait, it worsens the state that you are in.

"It has caused me all kinds of problems. I have quite bad scars on my legs from self-harming due to not being able to see a doctor, get any medication or any help when I have been in distress."

There are 24 different primary care centres, mostly attached to hospitals, which provide out-of-hours cover when GP surgeries and clinics are closed. Calls are handled by the health board or NHS 111 service.

The research also revealed how the problems contribute to significant delays faced by patients with several health boards significantly breaching targets for how long it takes to see urgent cases calling the out-of-hours service.

Groups representing GPs have long warned that out-of-hours services in Wales are in "crisis".

An earlier BMA Wales survey found exhaustion was the main reason GPs did not sign up for out-of-hours shifts.

Chairman of the BMA's Welsh council, Dr David Bailey, said the latest findings were "no surprise". He said out-of-hours working often produced acute cases which added to pressures.

A recent report by the community health councils in Wales found too much out-of-hours GP care was patchy and recommended new ways it could be provided.

Meanwhile a recent Wales Audit Office report warned that while out-of-hours services are appreciated by patients, national standards were not being met due to morale and staffing issues.

Chairwoman of the Royal College of GPs in Wales, Dr Rebecca Payne, said the data was very concerning and added to mounting evidence that out-of-hours services were unsustainable.

The college has also launched an action plan outlining five steps to turn the services around, including increasing the number of trained call handlers.

Dr Payne said: "The Welsh Government and local health boards need to take heed of our recommendations and take urgent action to improve the services. They owe it to the staff working in the services and the patients trying to access them."/more.

A Welsh Government spokesperson said: "We expect health boards to provide care to meet the needs of patients out of hours, and make best use of all multi-disciplinary professionals.

"Whilst a recent Wales Audit Office patient survey revealed that 89% of respondents rated the service as excellent, or very good, we are working with health boards to improve out-of-hours services further."