Table 2

Impact of out of hours (OOH) environment on practice

ThemeExamples
Lack of background information and lack of clarity about agendaChallenging because you don't know the patients (9); whose agenda? (6); you don't have access to the records (16);
Approach to patientI'm not quite so patient centred…a bit of fire fighting …don't want to miss critical things and if there's a red flag symptom that comes up…[it] doesn't need to be acted upon (15);
Lack of follow-upThe sad thing about out of hours is that you don't follow-up on most of your patients (18);
Lack of feedbackin reality as an out of hours presentation it is quite difficult to find out what the discharge diagnosis was (17);
Attitude to worka rewarding part of my work…best provided by experienced general practitioners (11);