Risk taking in general practice: GP out-of-hours referrals to hospital.

Background: Emergency admissions to hospital at night and weekends are distressing for patients and disruptive for hospitals. Many of these admissions result from referrals from GP out-of-hours (OOH) providers.

Aim: To compare rates of referral to hospital for doctors working OOH before and after the new general medical services contract was introduced in Bristol in 2005; to explore the attitudes of GPs to referral to hospital OOH; and to develop an understanding of the factors that influence GPs when they refer patients to hospital.

A qualitative study exploring variations in GPs' out-of-hours referrals to hospital.

Background: There is evidence of significant variations in hospital referral rates for GPs working in out-of-hours care.

Aims: To explain why there are marked variations in hospital referral rates for GPs working in out-of-hours care.

Design Of Study: In depth, face-to-face interviews with a purposive sample of GPs with different out-of-hours referral rates.

An observational study of variation in GPs' out-of-hours emergency referrals.

Out-of-hours organisations are responsible for the care of patients 70% of the time, and their GPs act as gatekeepers to secondary care services. This observational study identifies the variations in GPs' out-of-hours referral rates to secondary care and factors that could explain these variations. One hundred and forty-nine GPs who worked in one UK general practice out-of-hours cooperative which served 19 practices with 167 000 registered patients.