Telephone advice for out of hours calls in general practice.

Telephone advice in out of hours general practice consultations has been infrequently described in the United Kingdom. Data from 13 general practices (77 doctors) in north London were collected over four-week periods. Of the 970 calls recorded, 86% were managed directly by the practice, and 14% by a deputizing service. The percentage of calls managed by telephone advice varied from 5% to 57% (mean 37%). Use of deputies increased at night, but general practitioners remaining on call maintained their telephone advice rates. In all but one practice trainees also gave telephone advice, but the overall proportion of calls managed by trainees (33%) was lower than that of principals (48%). Children and adults under 60 years, more frequently received telephone advice than elderly patients, as did patients noted by the general practitioners as habitual callers compared with other patients.