Brian Murphy, manager of Westdoc, the out-of-hours GP service, says some days his day never ends
Westdoc, the out-of-hours GP service in the Western Health Board area has been operating since December 2002 and has had over 75,000 patient contacts to date. Westdoc is a new and unique system of providing care to patients requiring urgent GP care in Galway, Mayo and Roscommon. About half of the GPs in the region participate in Westdoc and the service is provided to patients of these participating GPs.
I started working on Westdoc in July 2001 and since its beginning I have been managing its day-to-day operations and its development. I previously worked in the Department of Health and Children for 15 years and my current "coal-face" work has been an exciting change from the policy-making work of the Department.
My typical working day involves a 30-minute, 14-mile drive to the Westdoc headquarters on the periphery of Galway. I usually arrive at work before 9 a.m., but this can often vary if early morning meetings are required. My arrival usually coincides with the finish of the night-shift and it gives me an opportunity to discuss any issues arising with the call centre staff.
Having looked at the activity levels of the previous evening and night, I meet my colleagues to plan work and to share information and ideas on aspects of our work.
The GPs are very much involved in the operational and policy-making of Westdoc. This partnership structure with the Western Health Board is ground-breaking as, historically, GPs operated as individuals or in small group practices and, as individuals, were not central to decision-making. Such participation has, undoubtedly, helped to build better trust, understanding and awareness.
Preparation for meetings and discussions with GPs take up a considerable amount of my time. It is important in my role to be accessible for all 107 participating GPs and for potential new entrants.
Meetings with GPs are almost always at night resulting in a lot of out-of-hours work for me. I'm often reminded of the quote by poet Robert Frost: "By working faithfully eight hours a day, you may get to be a boss and work 12 hours a day."
Our office premises are new and modern and I try to promote a healthy working environment for all at Westdoc. The staff, triage nurses, drivers and call handlers at Westdoc are thorough professionals and work together in a very patient-focused way. They have created a dynamic and friendly work environment built on an underlying positive, progressive and co-operative ethos.
The out-of-hours service is primarily for urgent cases requiring GP attention. Our team of specially trained triage nurses provide advice to patients when they do not need to see a GP. This part of the service has received immense positive feedback.
I tend to deal directly with patient queries and most patients are supportive of the concept and we value patient feedback on patients' experiences. I'm regularly on-call for emergency issues arising with the service and on some days my working day never ends. Nevertheless, through our shared experiences with other co-ops we have been able to minimise the frequency of these issues arising, thereby reducing the number of times I am contacted, thankfully.
I look forward to the challenge of expanding Westdoc to all areas in the region, and I am confident that our pioneering work will influence and help to shape future health developments both in the region and nationally.
(Interview by Michelle McDonagh)