After-Hours Care in the UK: Available on Paper, But Not in Practice

According to The Commonwealth Fund, “[o]nly 29 percent of U.S. physicians said their practice had arrangements for getting patients after-hours care — so they could avoid visiting a hospital emergency room. Nearly all Dutch, New Zealand, and UK doctors said their practices had arrangements for after-hours care,” including 89 percent of UK practices.

While UK after-hours care may look good on paper, the online Telegraph reports that only 1 in 4 people who want after-hours care actually sees a physician in the parts of the UK with the best after-hours performance. In the sections of the country with the worst performance, only 1 in 50 people actually gets the after-hours care they want.

The bureaucrats who administer the system emphasize that “it’s better than it was in 2004.” They worry more about the “level of variability” than the fact that people don’t get to see a doctor when they feel they need to.

As an earlier post on this blog pointed out, Commonwealth appears to ignore the fact that after-hours care in the U.S. is increasingly specialized. Rather than relying on their primary care physicians, who, after all, need their sleep, U.S. patients who need after-hours care may rely on one of the country’s 8,000 urgent care practices.

Unlike their British counterparts, U.S. patients who need after-hours care can actually get it. They have the luxury of getting care from a system that looks bad in Commonwealth Fund paper, but performs fairly well in actual practice.

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