Doc on Call, SCR

candy19

Hi all,
I was just wondering if anyone knew if there was any charge for the doc on call service on south circular rd if you are a Gms patient...?
And if anyone knew what hours they operate...and if you go to them or they come to you??
Any help would be much appreciated...

DrIndy

I'll wait for a couple of our GP boards colleagues to spot this thread.

To the best of my knowledge - it is still free if you are GMS. You should contact your own GP to see which out-of-hours service they are a member of. Logically this service may be closer to you - but they are divided up per population and per GP and the actual out of hours service may be somewhere else for example - they may be part of DubDoc which is based out of St. James's Hospital

In general, they only do house calls at night if it is very urgent and you truly cannot attend the surgery. Remember that all the facilities, instruments and backup are in the out of hours office and so it is in fact better for you to pop over there than to get a house call if possible.

drzhivago

DrIndy wrote: »

To the best of my knowledge - it is still free if you are GMS.

Free if you can access and depends which service it is

Contactors and Doctor on Duty are the two long term night cover providers in the city, did work for both over many years as a young junior doctor

If you have medical card the doc comes out and treats then gets you ti sign a form which they use to reclaim payment from GMS Board

They may ask to see card although that is no guarantee nowadays that the card is valid

DrIndy wrote: »

You should contact your own GP to see which out-of-hours service they are a member of. Logically this service may be closer to you

Perverse but no it will be the service that is closest to GP practice and not the patient address although for GMS the address may be close but if person moved to another area they may still have retained original GP

Best to ask GP

DrIndy wrote: »

- but they are divided up per population and per GP and the actual out of hours service may be somewhere else for example - they may be part of DubDoc which is based out of St. James's Hospital

Not all Gps linked to these services some still linked to Doctor on Duty or contactors as described above

DrIndy wrote: »

In general, they only do house calls at night if it is very urgent and you truly cannot attend the surgery. Remember that all the facilities, instruments and backup are in the out of hours office and so it is in fact better for you to pop over there than to get a house call if possible.

Completely agree but logistically in city may be difficult to get to the GP centre covering if no direct route so understand that issue

I often wondered while doing these shifts and spending hours driving to people irate at having to wait for me to find house in housing estate I had never been to why I was not based at a central point and a driver sent to bring patients to me, less wait for them, easier for me to see more people and less wasted time driving to places I could not find although that is a lot easier with GPS now

AmcD

drzhivago wrote: »

I often wondered while doing these shifts and spending hours driving to people irate at having to wait for me to find house in housing estate I had never been to why I was not based at a central point and a driver sent to bring patients to me, less wait for them, easier for me to see more people and less wasted time driving to places I could not find although that is a lot easier with GPS now

I can't see the HSE agreeing to this. Can you imagine the abuse of the system if people thought the HSE would provide a free taxi there and back to see a doctor at night? It is bad enough with people calling the big white taxis to get to A+E.
But I see your point. Most of the shift doing housecalls is spent looking for the houses. It is a waste of time and resources. That same doctor could see six sick children in the out of hours centre in the time it takes to do one housecall.

RobFowl

AmcD wrote: »

I can't see the HSE agreeing to this. Can you imagine the abuse of the system if people thought the HSE would provide a free taxi there and back to see a doctor at night? It is bad enough with people calling the big white taxis to get to A+E.
But I see your point. Most of the shift doing housecalls is spent looking for the houses. It is a waste of time and resources. That same doctor could see six sick children in the out of hours centre in the time it takes to do one housecall.

The Canadian system works on the basis that if tou are too sick to come and see the GP that you should go to AE/hospital hence no house call and a lower AE attendance rate as well. It's all about attitudes :rolleyes:

D-Doc which covers noth Dublin has a house call rate of less than 10% and any doc doing these car shoft would tell you the vast majority are unwarranted.

tallaght01

RobFowl wrote: »

The Canadian system works on the basis that if tou are too sick to come and see the GP that you should go to AE/hospital hence no house call and a lower AE attendance rate as well. It's all about attitudes :rolleyes:

D-Doc which covers noth Dublin has a house call rate of less than 10% and any doc doing these car shoft would tell you the vast majority are unwarranted.

I'm inclined to agree with the Canadians. I think housecalls for emergencies are outdated, and really unneccessary.

AmcD

I am impressed that the Canadians have an official policy like that. I do car shifts for DDoc. There are so many bogus calls. The worst ones are when people say they have no transport to get to a centre and therefore need a housecall. Presumably the HSE also takes them shopping and collects their social welfare payments.
Having said that, I did a shift in February and was stunned to visit only sick elderly people. It had never happened before.

RobFowl

AmcD wrote: »

I am impressed that the Canadians have an official policy like that. I do car shifts for DDoc. There are so many bogus calls. The worst ones are when people say they have no transport to get to a centre and therefore need a housecall. Presumably the HSE also takes them shopping and collects their social welfare payments.
Having said that, I did a shift in February and was stunned to visit only sick elderly people. It had never happened before.

Hi AMcD
Tend to avoid the car shifts 'cos got so frustrated seeing tons of inappropriate stuff:(
Once goat an urgent HC for an elderly lady who had "fallen" turns out her son called it in , hadn't told her. (hadn't even bothered to visit her himself) and suffice to say she was mortified (and totally uninjured) as well as surprised.:eek:

AmcD

I have to say I have stuck to the centre shifts due to frustration with car shifts too.
My favourite call (details changed slightly so as not to identify anybody):
Young person goes out for a walk at the weekend. Slip and very minor bang to their head. The next day their head is a bit sore. They ring DDoc for an appointment to be seen at the local out of hours call centre.
The triage nurse can't get through to this person to discuss the details and assign an appointment. After multiple calls the nurse activates an emergency housecall as it is a possible head injury.
Myself and the driver have to cross the city and divert from other calls. We reach the house and knock on the door. The person who answers door doesn't seem surprised to see us. I find the person who made the call and explain why we are attending an emergency housecall. They see that their phone has a load of missed calls, but they don't seem particularly bothered. There is no apology for wasting our time. The "head injury" is too trivial to even cause a bruise or bump.
Icing on the cake: the patient's companion asks me to look at a minor complaint that has been bothering them for a while. I don't oblige.

RobFowl

AmcD wrote: »

Icing on the cake: the patient's companion asks me to look at a minor complaint that has been bothering them for a while. I don't oblige.

Got that too
Details changed a little but housecall (genuine ) to frail elderly lasy with chestinfection on a backround of CCF. Saw her sorted her and as I wa leaving her nice appeared saying she heard I was here and needed her OCP repeat.
Pretneded not to hear and walked on (seething inside )

Over all how do you find D-Doc i feeling its working well (I have a bias BTW)

AmcD

This is going to drag things off topic.

DDoc:
I think it is great that there is such accessibility so that people can easily get appointments out of hours. It is also a great idea that full members/principals are made to do shifts so that the service is not run by ENT regs (no disrespect to ENT regs, but fulltime GPs should be doing the bulk of the work as it is a service for them). The fax system to forward details of all patients seen is great for letting us know what goes on out of hours.

But there are some things I would do a little differently. Having experienced doctor-lead triage (NEDOC), I think that it works better. Nurses understandably have to stick to protocols, whereas doctors have much more leeway to make judgement calls as they can take full responsibility. There would probably be a much higher rate of calls completed by telephone advice alone. I can understand that it is probably a question of resources.
One thing that would improve the service would be a formulary. Why is it that every child with a viral illness gets augmentin duo, or worse still, klacid? Could there be a rule about (appropriate) generic prescribing?
That leads me to my second point. I recently grabbed a fax out of the machine and excitedly read that a doctor gave reassurance and paracetamol to a child with a viral illness. This takes courage and I know that there is pressure to always give a prescription (unfamiliar patient, expectations of getting a script, easier not to do the whole virus explanation). Maybe this could be helped by having explanatory leaflets for common conditions so patients don't feel fobbed off.

Well you did ask.