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Lets be honest about this to get the type of OOH service the patient expects and was delivered in 2004 by GP practices Cooperatives the funding needs to be increased by around 30/40% and local GP s paid around an Average of £125 per hour the correct rate for a GP working additional hours. Lets remember the contract was all about recruiting GPs on the understanding they never needed todo OOH. So reduction in good quality GPs who can respond to the very different clinical demands of OOH. CCGs pay up and take the flack of supporting your own but at least a chance of a good OOH service which reassures the patient they are getting a good service will use it and not divert to A&E etc. I understand that clinically it may not be essential but the patient has been told they must get a good service.