(Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey)
The extent to which deprivation influences the demand for out of hours medical care is not fully explained. In a six month study published in this week's BMJ, Carlisle et al investigate the level of our of hours activity in six general practices and the sole accident and emergency department in Nottingham. The authors found that highly deprived areas close to the A&E department generated high levels of work for both general practice and A&E services, with no evidence of one service substituting for the other. Carlisle et al conclude that those involved in changing out of hours services should take into account the wide variations in demand and note that a disproportionate amount of activity falls on deprived inner city practices, which should be supported in order that they are able to provide good quality out of hours care.
Robin Carlisle, Lecturer, Division of General Practice, University of Nottingham, University Hospital, Nottingham