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13-09-2012 | General practice | Article

Out-of-hours key to acute care crisis


RCP Report – Hospitals on the edge? The time for action

medwireNews: Poor access to GP out-of-hours services is contributing to a crisis in acute care, the Royal College of Physicians says.

In a damning report suggesting that hospitals are "on the brink of collapse", the RCP suggests that failings in out-of-hours care are compounding the problem of increasing hospital admissions at a time when beds are being cut.

Among a series of recommendations, the report calls for "access to primary care to be improved so patients can see their GP out of hours, relieving pressure on A&E services".

The report shows that hospitals have seen a 37% rise in emergency admissions over the past decade, while there are a third fewer general and acute beds than 25 years ago.

While emergency admissions are around 25% lower at weekends than during the rest of the week, they account for the greatest burden of weekend hospital-based clinical activity, the RCP says. Patients admitted at the weekend do not get diagnostic tests as quickly as those admitted during the week, and fewer are discharged, with knock-on effects in the following week.

"Despite the high cost of hospitalisation, the NHS has been slow to develop comprehensive, effective alternatives to admission. Although patients become acutely ill 24 hours per day, 7 days per week, the current drive to 7-day working in secondary care is not being matched in the community," the report states.

RCP President Sir Richard Thompson said: "One doctor told me that his trust does not function well at night or at the weekend and he is 'relieved' that nothing catastrophic has happened when he arrives at work on Monday morning.

"This is no way to run a health service. Excellent care must be available to patients at all times of the day and night. We call on government, the medical profession and the wider NHS to work together to address these problems."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price