The off-duty arrangements of general practitioners in four European countries

Continuity of care has been regarded as an essential feature of good general practice. It may be jeopardised by many diverse factors such as the mobility of the population, a shortage of family doctors, and by some forms of group practice. A shorter working week which many doctors enjoy or anticipate is another threat to continuity as it increases the time off duty and leads to the frequent use of rotas and deputising services.Criticism of the off-duty arrangements of family doctors has been made not only in the United Kingdom, but also elsewhere in Northern Europe. A study of the systems used or planned in four different countries is described and compared with some of the deputising arrangements commonly used in the United Kingdom.Research is required to elucidate whether continuity is fundamental to good medical care and how it can be achieved, bearing in mind the needs of both patient and doctor.