The majority of GPs no longer offer out-of-hours care
GPs should reclaim responsibility for out-of-hours care in England, an influential group of NHS staff says.
The NHS Alliance said patients had lost confidence in the care, often provided by private firms since the GP contract saw 90% of family doctors opt out.
It said GPs should club together to take charge of night and weekend care, although this could mean buying in nurses, paramedics and doctors.
But the government said the current arrangements were working well.
Under the terms of the 2004 GP contract, family doctors were allowed to opt out of out-of-hours care.
Over 90% did so, handing over responsibility to local health chiefs working for primary care trusts who have often relied on private firms to cover at nights and weekends.
The changes have led to a surge in complaints and have prompted the Tories to call for GPs to take back responsibility in a similar way as the NHS Alliance is suggesting.
The group, which represents NHS professionals working outside hospitals, including some GPs, said there was confusion over the complex arrangements now in place.
NHS Alliance chairman Dr Mike Dixon said patients were often presented with several choices, including NHS Direct, walk-in centres, A&E and out-of-hours providers, and did not know when to go where.
"We have a system whereby there is a void when GP services close for the day.
"I think many doctors are concerned about this."
He said taking back responsibility for out-of-hours care would not necessarily lead to day-time GPs covering nights and weekends - although some may want to on a rota basis.
Instead, partnerships between local GPs could take charge and either buy in teams of nurses, paramedics and other doctors or keep the existing private firms in place.
Mr Dixon said: "The bottom line is that the people responsible for day-time services would be also accountable for out-of-hours. I think this will be better for patients."
A spokeswoman for the Patients Association said: "Patients would be delighted if this was to happen."
But the British Medical Association, which negotiated the out-of-hours opt-out as part of the 2004 deal, is sceptical.
Dr Richard Vautrey, deputy chairman of the BMA's GPs committee, said: "I think primary care trusts should involve GPs more in decisions about out-of-hours care."
But he added doctors would not want to be responsible for providing services in a situation where alternative providers could not be found.
The Department of Health said GPs had already made it clear they did not want out-of-hours responsibility, adding the current system had meant improvements in day care.
"Patients now benefit from longer consultations, quicker appointments and being able to book ahead."