One out-of-hours GP for 185,000 in Norfolk

The full extent of the problems patients in Norfolk face reaching doctors in the evenings or at weekends was outlined today as it was revealed just one GP is on call for 185,000 people.

Four doctors work out-of-hours shifts between midnight and 8am for a population under NHS Norfolk of about 740,000 - leading to concerns over safety and access for sick patients.

NHS Norfolk buys health services for people in Norfolk (excluding Great Yarmouth) and commissions the out-of hours service from the East of England Ambulance Service.

North Norfolk MP and Lib Dem health spokesman Norman Lamb said: 'This lack of doctors is unacceptable and it means at certain times there is not enough cover for patients.

'Given the wide rural area in Norfolk with enormous distances that need to be travelled it is even more worrying. There is a total lack of confidence in the out-of-hours system and it needs to be urgently overhauled.

'Patients need to know if they are sick in the night or at weekends there is enough cover and they have not go that reassurance at the moment.'

The spotlight has fallen heavily on out-of-hours services recently following the death of a 70-year-old patient who was given a massive overdose of diamorphine from a locum doctor from Germany who had flown in for his first out-of-hours shift.

This week a coroner is expected to conclude the inquest into the death of David Gray from Manea, Cambridgeshire who died in February 2008 after being given the drug by Nigerian-born Daniel Ubani.

The case has raised serious questions about 'stretched' out-of-hours service, from which GPs were allowed to opt out as part of the 2004 contract changes.

The latest research was carried out by the Daily Mail and other newspapers and it revealed in some areas in the country there was one doctor available for 310,000 people.

However health bosses said the four GPs covering shifts only fall on 'low demand' periods.

A spokeswoman for the East of England Ambulance Trust said out of hours shifts are filled from a pool of 125 GPs, the majority of whom are GPs working in general practice in Norfolk and North Suffolk.

She said: 'The figures given in national newspapers are misleading in that they only refer to cover from midnight to 8am which, research has shown, is our quietest time, and do not take into account our team of highly skilled emergency care practitioners.

'Prior to midnight we have three more GPs, making seven in total. Furthermore five emergency care practitioners complement the GP cover we have for all out-of-hours shifts and the service is also staffed by nurse practitioners at busier times.

'We provide a good well-resourced out-of-hours service which meets the demands and needs of the county.'

In Suffolk there are two doctors covering 600,000 people.

In 2004, the new contract for doctors split the responsibility between in-hours and out-of-hours care, making GPs responsible for care only between 8am and 6.30pm and it fell to primary care trusts to commission the out-of-hours service.