EMERGENCY out-of-hours GP services in York and North Yorkshire could face a radical overhaul, a leading York doctor has said.

Dr Brian McGregor was speaking after health chiefs announced the organisation responsible for the vital service was facing "potential financial challenges".

The York-based North Yorkshire Emergency Doctors (NYED) co-operative said yesterday that it was looking at ways of making its service as efficient as possible.

Dr McGregor, who works as a duty GP for NYED, said he believed that proposed changes could see paramedics and nurses sent to out-of-hours emergency incidents previously dealt with by doctors.

NYED representatives remained tight-lipped about the new arrangements, but reassured patients that the quality of the service would not be affected.

The organisation is in talks with local primary care trusts (PCTs) to identify solutions to the difficulties it faces operating in rural parts of North Yorkshire.

There are up to 14 GPs on duty at any time to provide out-of-hours care to the entire North Yorkshire area. Similar services in urban areas require only three GPs to maintain the same level of provision.

Dr McGregor, a member of the North Yorkshire Local Medical Committee, a body representing all NHS GPs in the area, said: "These changes are a necessary evil. Everything is changing and it will be interesting to see how it develops, but I believe the plans are ultimately to give an appropriate response to requests for out-of-hours care, which will include not just doctors but nurses and paramedics.

"Whether the public perceive this as a downgrading of the service is for the public to decide. It has the potential to remain an excellent service, but it does need to be closely watched."

He said he believed unnecessary calls from members of the public had contributed to the need for change.

Speaking on behalf of the PCTs involved, Penny Jones, chief executive of Craven, Harrogate and Rural District PCT, said: "We have been in talks with NYED about what support we can give them, and have agreed to provide a small project team to work with managers at NYED. This is an administrative issue and will not affect the service available to patients.

Dr Jamie MacLeod, chairman of NYED, said: "We are working together to continue a service which has been working well for many years. We would like to reassure patients that we are committed to ensuring a high quality local out-of-hours service continues to be available."

Updated: 10:59 Friday, December 10, 2004