Services We Provide

Today, Devon Doctors' main activity is still to provide out of hours urgent cover to GP practices across the county.

Accessing the out of hours service – the patient pathway

When a patient falls ill outside of practice hours, they are advised to ring their local GP practice as usual. The practice answer phone will provide the patient with the option of calling 999 for emergencies, NHS Direct for health advice or Devon Doctors for a doctor. A call to Devon Doctors is answered by a non-clinical call taker who takes the patient's demographic details and a brief description of the symptoms. The call is then despatched to a doctor who is based at one of our treatment centres across the county. The doctor returns the call and there are a number of possible outcomes:

Problem resolved with telephone advice from the GP
Patient is seen at a nearby Treatment Centre
Patient visited at home. (Devon Doctors has a fleet of 8 operational cars and 2 back-up cars)
999 called for an ambulance

Details of the contact with Devon Doctors are sent electronically to the patient's registered GP by 08:00 the following working day.

Services Nationally Devon Doctors has an excellent reputation as an out of hours provider and we are always working to meet and improve on our high standards, and the expectations of our patients.

National guidelines for GP making out of hours home visits

Devon Doctors prioritises which patients should get visits based primarily on clinical need with an urgency grading applied on each occasion. However, the on call GPs consider each case on its own merits and use a common sense approach where the circumstances dictate or require it. The clinical issues to consider include:

The grading at triage stage and If the patient has palliative care needs
Does the patient have a ‘special’ message in their record that would indicate a more urgent approach
Level of pain and level of respiratory distress
The age of the patient

Other factors, sometimes non-clinical, that need to be considered and balanced include the:

Time delay since initial call.
Geography to minimise driving time.

Alongside the above clinical criteria for prioritising visits, there are also general visiting guidelines we have adopted after agreement with both the Devon Local Medical Committee and the National Association of GP Co-operatives. They are:

1. A GP home visit is recommended when…

GP home visiting makes clinical sense and is the best way of giving a medical opinion in cases involving:-

The terminally ill
The truly bed-bound patient, for whom travel to premises by car would cause a deterioration in their medical condition or unacceptable discomfort

2. A GP home visit may be useful when…

After initial assessment over the telephone, a seriously ill patient may be helped by a GPs attendance to prepare them for travel to hospital – that is, where a GPs other commitments do not prevent him/her from arriving before the ambulance.

3. A GP visit is not suggested when…

In most of these cases, to visit would not be an appropriate use of a GPs time in cases of:

Common symptoms of childhood: fevers, cold, cough, earache, headache, diarrhoea/vomiting and most cases of abdominal pain. These patients are usually well enough to travel with their parents by car. It is not necessarily harmful to take a child with a fever outside and a hospital unit is often the best place for a child to be seen to allow quick emergency treatment if needed.

These children may not be fit to travel by bus or to walk but it is not a doctor’s duty to arrange their transport and would seek to confirm if car transport could be available from friends, relatives or by taxi.

Adults with common problems such as a cough, sore throat, influenza, back pain and abdominal pain are also readily transported by car to a doctor’s premises.

Common problems in the elderly such as poor mobility, joint pain, and general malaise would also best be treated by consultation at a doctor’s premises. The exception to this would be the truly bed bound patient.

Emergency out of hours dental service

This service is for registered and unregistered patients who live in Devon, and holiday makers and visitors to Devon. Patients will be offered an appointment if they are in need of relief from severe dental pain, acute infection, bleeding or trauma.

We run clinics from Dental Access Centres in Barnstaple, Exeter, Newton Abbot and Plymouth. Appointments are available Saturdays, Sundays and Bank Holidays and can only be booked by ringing 01392 823682 from 6pm on a Friday evening. Please note that we cannot book appointments before this time.

Patients offered an appointment will need to take with them the means to pay the NHS fee, or proof of exemption from charges. Nearly all treatments will be covered by the new Band 1 charge of £15.90. However, it is possible that treatment may fall into the upper band of £43.60, so patients should be prepared to pay this amount. Payment can be by cash or cheque only, patients without access to proof of exemption can re-claim fees paid at a later date.