Time for change
An NHS patient will almost certainly be impressed at the quality of medical care provided by the service but will also meet with frustrations. One obvious problem is the number of boundaries that exist between different parts of the service that generate communication difficulties and often leave the patient wondering whom to turn to next for advice or help. Of those many boundaries, one of the most important is that between "working hours" and "out of hours" (OOH) – the label (excuse?) used by the NHS to provide only a partial service for something approaching 75 per cent of the time.
There is a great deal of sense in having peak periods of activity during the normal working day when medical services are at their busiest, but the delineation into "working day" and OOH as at present does appear to leave expensive equipment underused for much of the time. Should the NHS not be taking a more radical approach in terms of seeking to provide a more continuous standard of care on a 24-hour basis – and making far more efficient use of the facilities available. We have a prime example in the 999 emergency service. I have no idea how this is managed on a 24-hour basis, but I have reasonable confidence that, no matter when a 999 call is made, someone will respond and relevant medical expertise will be made available.
T HEGARTY
Biggar Road