title: Out-of-hours medical cover in community hospitals: implications for palliative care.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Arrangements for out-of-hours medical cover in community hospitals are in transition, threatening the continuity of care for dying patients.
authors.affiliation: Wessex Institute of Health Research and Development, University of Southampton, Bassett Crescent East, Southampton, UK. clk@soton.ac.uk
authors.forename: Chris
authors.initials: C
authors.lastname: Kerr
authors.forename: Sheila
authors.initials: S
authors.lastname: Hawker
authors.forename: Sheila
authors.initials: S
authors.lastname: Payne
authors.forename: Mari
authors.initials: M
authors.lastname: Lloyd-Williams
authors.forename: David
authors.initials: D
authors.lastname: Seamark
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000458:organization & administration; D004739:England; D005194:Family Practice / Q000458:organization & administration; D005544:Forecasting; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006742:Hospital Bed Capacity; D006764:Hospitals, Community / Q000458:organization & administration*; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D010166:Palliative Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D013222:State Medicine / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013997:Time Factors; D014852:Wales