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Out-of-hours medical cover in community hospitals: implications for palliative care.

BACKGROUND: The new General Medical Services contract in England means many GPs have transferred out-of hours work to their primary care organization, with implications for continuity of palliative care in community hospitals.

AIM: To examine existing arrangements for out-of-hours medical cover in community hospitals, focusing on palliative care.

METHODS: Telephone survey of community hospital managers/senior nurses across England and Wales.

RESULTS: Interviews (n = 62) revealed nursing staff were satisfied with existing out-of-hours care. Concern was expressed about the future of out-of-hours medical care from GPs as new services will cover larger areas, meaning unknown doctors may attend, taking longer to arrive.

CONCLUSION: Arrangements for out-of-hours medical cover in community hospitals are in transition, threatening the continuity of care for dying patients.

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