Twelve months of deputising: 100 000 patient contacts with eighteen services.

An analysis of a 1-in-5 sample of nearly 500 000 patients contacts with 18 deputising services showed considerable variation in the way cells were handled. Telephonists, usually work on shifts including at least one operator who was a trained nurse handled, without sending a deputy, between 3% of new calls at one service and 19% at another. In one service, 19% of visits were made by deputies who were general practitioners; in another, 78%. At least 42% of patients visited by one service were apparently seen within one hour; 74% by another service. The proportions referred to hospital varied from 9% to 16%. The use of deputising services continues to grow; there is as yet no substantiated evidence of shortcomings in the care they provide. The possibility of reviewing the activity of the services, with the use of such indices as those described, might enable present limitations on their use to be lifted.