Table 1

Participants' perceptions of out of hours (OOH) environment (quotes in italics, numeric refers to interviewee ID). Emerging themes to question: How is the OOH environment different from normal practice and how does it impact on your practice? Frequently these comments came up spontaneously

Theme	Example
Avoiding hospital referral	avoid hospital…indication [to refer only if] either further assessment is required or there is some definite intervention that the hospital can provide (11); intravenous fluids which of course can't be given in the GP context (13);
Fire fighting	only deal with the immediate situation that's sort [of] a bit of fire fighting (12); what can we do to make sure he's safe to be seen by his GP in the morning or do we need to admit him tonight (3);
Time pressure	not doing the other patients a service if they are sitting out there waiting (19);
Practising in an unfamiliar environment	easier to practise medicine in your own environment (5);
High-risk patients	see a high proportion of high risk patient in out of hours…frightening sometimes (21);