GP out of hours services

Harmoni has over 15 years experience of delivering full GP out of hours services across England. We were one of the first providers to set up an NHS exemplar site, based in West London, and have become the largest provider of full out of hours services in the country covering over eight million patients.

In his independent review of GP full out of hours services in England, Dr David Carson stated in his "Raising Standards for Out of Hours Care" of 2000 that:

"Patient access to out-of-hours care should be as simple and straightforward as possible –one telephone call, providing effective and timely advice and, where necessary, a face-to face consultation at a time and place agreed with the patient."

This is the premise on which our full out of hours services are designed and delivered.

Harmoni's full out of hours service model has six key components: access, assessment, signposting and booking of appointments, treatment, self management and planning.

Access

Patients are able to access the service via a dedicated phone number. If they call their own GP surgery first, they will either be transferred directly, or played a recorded message telling them the correct number to ring. All surgeries are given patient leaflets and posters explaining when and how to access the full out of hours service.

All calls to our service are answered by one of our experienced call handlers who takes the patient's demographics and details of their medical condition. The call is prioritised and forwarded to either a GP or nurse for assessment. All of our phone calls are recorded for audit purposes and kept for up to five years.

Assessment

Once the GP or nurse has received the patient's details, they call the patient back for an assessment over the phone and a discussion about their medical need.

Signposting and booking

Once the clinical assessment has been completed, the patient will then be given a number of options:

• Advice over the phone about how to look after themselves without having to see a clinician
• An appointment to see a GP at the primary care centre closest to them
• A home visit by one of our clinicians
• A visit by one of the community nursing teams
• A referral on to A&E or hospital where appropriate
• If the patient has a life threatening condition, our call handlers and clinicians are able to refer them to the 999 ambulance service

Our team will ensure that the patient understands the next steps in the process, and that the service to which they are being referred has all the necessary information about their medical need.

Treatment

Our GPs and nurses see patients face-to-face in either a primary care centre or, if absolutely necessary, in their own home. Our primary care centres are usually situated in local hospitals or community health centres.

Planning

Harmoni is required by the Department of Health to report regularly to commissioners on our achievement against the National Quality Requirement (NQRs) standards. We have an excellent reputation for delivering fully "green" NQR reports, and pride ourselves on our ability to address and quickly resolve any issue that may be highlighted.

We are also able to provide our commissioners with information about the onward referrals made for patients during the full out of hours period as well as the GP practices with which patients are registered. The wealth of data held within the service systems can provide commissioners and service improvement teams with valuable information to help their future planning and capacity building.