GP Out of Hours Service Celebrates 20 years in the North Down and Ards area


North Down and Ards Doctors on Call (NDADOC) recently celebrated its twentieth birthday. NDADOC is part of the South Eastern Trust GP Out of Hours Service, which also covers patients within Lisburn and Downpatrick areas.

NDADOC was one of the first GP Cooperatives set up with local GPs and supported by the former Ulster Community and Hospitals Trust. This innovative scheme encouraged GPs to manage their 24 hour care obligation to patients by working together within a shared rota providing medical advice or face to face assessment when the GP surgeries were closed. Prior to this your local GP would have routinely worked a week on call, including the full weekend and holidays after working their normal daytime hours. This undoubtedly impacted on family life as patients contacted them at home and a family member had to take messages if the doctor was out visiting other patients.

NDADOC was set up as a private company limited by guarantee and was owned by local doctors and managed by a GP Executive Committee (Board of Directors). The former Eastern Health Board provided a proportion of administration costs but the medical costs were self-financing. Doctors in each practice had to work a pro-rata share of sessions to break even or pay for others to work on their behalf.

NDADOC originally employed part time day staff, receptionists and drivers on a sessional basis. There are 8 doctors, 9 receptionists, 3 drivers and 1 admin staff member who have been with the service since it began 20 years ago.

The original service was based in Balloo Training and Resource Centre (TRC) in Bangor until April 2005 when the service moved to the current base in Ards Hospital.

Mark Armstrong (Unscheduled Care Manager) was the original NDADOC manager and worked with GPs to set up this GP cooperative model. He said “This was a major undertaking as we needed all the doctors on board to fund this initiative and have enough doctors for this model to work. Local representative GPs such as Dr Joanne Drew, were critical to success as they influenced GP colleagues to become involved.”

Dr Joanne Drew was the NDADOC GP Executive Chairman. “We travelled to MEDDOC (Maidstone) to look at a GP Cooperative model in action. We were convinced this could work in our area. The National Association of GP Cooperatives (NAGPC) also provided invaluable support and everyone involved in cooperatives freely shared their ideas and resources. NDADOC also set up the first Regional NI OOH Group and NI OOH Managers Group with the other GP Cooperatives to share our ideas and learning across the province. ”

Dr Graeme Crawford (NDADOC GP / Director) said “The GP Cooperative model has been a very successful over the last twenty years. Patients are more willing to attend the out of hours for assessment. Telephone triage is widely accepted as doctors can get through their workload more efficiently and prioritise patients with urgent conditions for face to face assessment.”

Dr Michael Doyle (Peninsula GP) “This was very exciting as it was the first time GPs in the Peninsula and Lower Ards had the opportunity to meet and work with GP colleagues and to establish a wider clinical GP network.”

The South Eastern Trust (SET) GP Out of Hours Service (OOH) managed a total of 105,706 patient contacts during 2015-16 across the three centres. North Down and Ards is the busiest of our three OOH centres with 28,143 telephone advice contacts, 12,024 patients seen at the OOH centre and 3259 home visits. On average across the three sites the number of contacts has risen to over 2000 per week, resulting in increasing pressure on all of our centres.

The most recent Patient Satisfaction Survey 100% found it “Very Easy” or “Easy” to contact the GP OOH Service. 92.9% felt they were “Very satisfied” or “Satisfied” with GP Out of Hours Service experience. Patients commented that “The Doctor very sympathetic and understanding on the phone”, whilst another noted the security “of knowing your child can be seen at any time.”

The South Eastern Trust (SET) GP Out of Hours was built on the original NDADOC GP Cooperative model and remains an essential first point of contact for patients when their normal GP Surgery is closed. It is important patients ring us first so that the doctor can prioritise your care based on your clinical need. If you arrive without an appointment you will need to wait until a slot is available. It is important to remember that at peak times such as weekends and bank holidays the service will be busy even with additional doctors in place and that all calls are prioritised on the basis of clinical urgency.

Nicki Patterson (Trust Director) said “I’m delighted to add my congratulations to the GP OOH Service on this important milestone. The success of SET GP OOH Service is down to those loyal and committed GPs, receptionists, drivers, administration staff and management working together to deliver this essential service to our patients.”

Dr Colin Fitzpatrick (GP / Clinical Lead) commented “GP Out of Hours Services recognises our critical partnerships with other key services such Northern Ireland Ambulance Service, Police Service of Northern Ireland, Emergency Departments, GP Practices, District and Community Rapid Response Nursing Services to support our work. We look forward to the next decade with great interest. “

Pictured above, staff marking 20 years of working within the GP Out of Hours Service

Pictured above, Roisin McCartan GP Out of Hours Manager and Dr David Reid Medical Manager