5. Providing care out of hours; using locums, co-operatives, and deputising services
 

You must be readily accessible to patients and colleagues when you are on
duty.
You must be satisfied that, when you are off duty, suitable arrangements are
made for your patients’ medical care. These arrangements should include
effective handover procedures and clear communication between doctors.
If you are a general practitioner you must satisfy yourself that doctors who
stand in for you have the qualifications, experience, knowledge and skills to
perform the duties for which they will be responsible. A deputising doctor is
accountable to the GMC for the care of patients while on duty.
GMC Good Medical Practice, paragraphs 12.11, 34, 35

The excellent GP
- can always be contacted when on duty and arranges immediate action in an emergency situation
- only uses out-of-hours cover arrangements where high standards of care are provided
- checks the registration of locums with the GMC and only employs a locum who has provided a JCPTGP certificate (or a curriculum vitae if he or she entered practice before such certificates were issued) and two references from previous employers, and who has attained a high standard of practice (e.g. possession of the MRCGP)
- can demonstrate an effective system for transferring and acting on information from other doctors about patients

The unacceptable GP
- cannot be contacted when on duty, takes a long time to respond to calls, or does not take rapid action in an emergency situation
- has no knowledge of the qualifications of locums employed in the practice or ignores doubts about their ability
- has no system for transferring information about out-of-hours consultations to the patient's usual doctor
- does not follow up relevant information about his or her patients that has been provided by another health professional