Out of hours care for the practice is provided by the West CheshireOut Of Hours Service. This is a service set up by Cheshire West Primary Care Trust ( PCT ) together with Ellesmere Port, Central and Eastern Cheshire PCTs. The service is operated by the PCTs and  they , NOT the practices are  wholly  responsible for the service and for the standard of care it provides. This is a radical change from pre-2004 when practices individuallywere responsible for the provision of out of hours care.

From the point of view of the patient needing care outside of surgery hours, you will notice little change. As before all calls to Farndon Surgery outside of surgery hours are diverted to a central call handling centre. A call handler will take basic details and unless the call is an obvious serious emergency, all callers will discuss their problem with a Triage Nurse. Where the call is obviously a life threatening emergency then an ambulance is summoned immediately.

The Triage Nurses are a group of highly trained Nurses skilled in the assessment of problems by telephone. The triage Nurse will deal with the call in one of four ways.

1. The caller may simply require advice regarding minor illness that the Triage Nurse can deal with herself.

2. The caller is passed on to a Doctor for medical advice.

3. An appointment is made for the patient to be seen by a Doctor at one of the Primary Care Centres. Whilst there are others, the Primary Care Centres for Farndon are at Tarporley Cottage Hospital as before, but also now at St Martin's Clinic in Chester. The patient has the choice of where they wish to be seen. Until 2004 the clinic at Tarporley Hospital was the only place where a Doctor was available Out of Hours for patients of the Farndon Practice. This is no longer the case and many people will doubtless find St Martin's clinic to be easier.. It is on St Martin's Way next door to where the old Royal Infirmary used to be. There is easy parking here and the late night / Weekend pharmacy is only around the corner on Upper Northgate St. There are several other centers across the county, the choice of which centre to go to is up to you, the Nurse will go through the various clinic times with you.

4. For those too elderly or too immobile to attend a Primary Care Centre then a home visit by a Doctor or District Nurse will be arranged.

5. Where it is clear that the patient can only be adequately assessed in a hospital setting then hospital assessment will be arranged and ambulance transport organised where needed.

After 10pm at night until 8am the calls are handled by NHS Direct, but the arrangements for the patient to be seen if necessary remain the same. If a patient needs to see a Doctor at a Primary Care Centre but has problems with transport, the PCTs have a contract with a local Taxi company to transport patients to the centre and home for a cost of just £1. Clearly this is reserved for true medical need, not for a cheap ride into Chester!

The one big change from previous services is that Saturday morning is regarded as being Out of Hours and the Doctor's Surgeries will not be open. This is a National not a local change, so please don't blame us!

Other ways your call may be handled.

It is not infrequent in very urgent cases, for the Triage Nurse or Doctor on duty to redirect the call to the Ambulance Service rather than for the Doctor to visit. The reason for this is that as Medicine advances and more conditions are given acute hospital based treatments, the role of home treatment of serious illness is diminishing. Often what determines the outcome of an illness is the speed with which the patient can be got to hospital to be given life-saving treatment that can only be given in a hospital setting. The commonest example of this is with a suspected heart attack where the death rate is determined by the time from the onset of pain to the administering of a clot dissolving drug in a cardiac intensive care unit. Clearly in circumstances such as this it is inappropriate to wait for a Doctor to come to the house, especially as there is no useful action that the Doctor can take when he gets there. Small delays can make a big difference and literally make the difference between survival and death, because of this when the call center is contacted with symptoms suggestive of a heart attack an ambulance will always be sent to the patient rather than the Doctor visiting first. In this type of case the Doctor will visit as well if he is nearby, and a visit will be of any practical benefit but it is important for the Doctor not to hold up the transfer to hospital.


In these sort of circumstances patients are often surprised that the Doctor does not call first and then arrange hospital care if needed, based on the popular view of how Doctors used to practice. Such arrangements are not there to allow the Doctors to avoid home visits, but to ensure that patients get the treatment they need, in the often brief window of opportunity, when it can be given to the best effect.

Who Provides the care?

If you visit a Primary Care Centre, or get visited at home by a Doctor, the Doctor that you see will usually be a GP from the Cheshire West or Ellesmere Port area who has chosen to work an out of hours session. Much of the overnight work is provided by Doctors employed by the PCT specifically to provide this service, not by a GP who has to do his own morning surgery when he has finished the night shift.

Complaints Comments

If you have had reason to use the out of hours, Co-operative  and have any complaint or comment that you would wish to make, then please do so. Out of hours care is an important aspect of General Practice. As it is largely provided not by us personally, it is important that the quality of the service is every bit as good as if they had contacted us about the same problem during the normal working day

Please make any comments preferably in writing either  to us, at Farndon Surgery and we will pass it on or directly to the Out of Hours Service Manager. Her address is as follows.

Cheshire West and Ellesmere Port Out of Hours Service

St Martin's Clinic

St Martin's Way

 

Chester

Who should call out of hours

The out of hours service is an emergency service, it has never been intended that Doctors should be available 24 hours per day for routine matters. Basically the out of hours service is there to provide care for people who are taken suddenly ill, and who are too ill for them to wait to be seen, either at the next available surgery, or at home during the normal working day. Similarly if a previous condition should suddenly worsen it may not be appropriate for that person to wait to be seen during the working day.

It is not intended that the out of hours service should be used by people who have been unwell for several days but have not bothered to visit the Doctor during the day. Neither is it intended that the out of hours service should be used by people with minor illnesses, coughs colds flu etc. Most such conditions really do not need medical intervention at all, where a person feels that they need to see a Doctor with such conditions, quite adequate provision is made during normal surgery hours, there is no need for the out of hours emergency service to be involved.