And the county's health overview and scrutiny committee was warned doctors in other areas could find themselves taking calls from West Sussex patients and having no idea how to direct them to a hospital.

The Harmoni co-operative has recently taken over provision of the service, run for West Sussex Primary Care Trust, from three previous providers.

And the committee heard 184 local GPs had currently signed up to work for it, with all information systems, a call-handling service, primary care centres and mobile units in place.

Sara Weech, the PCT's director of strategy, said it was far too early to say anything about performance, but it was a case of so far, so good.

But Cllr James Walsh said the question of out-of-West Sussex triaging – triage is the assignment of degrees of urgency to decide the order of treatment – was very serious, and bothering local GPs.

The doctors were getting calls about patients in south London, and vice-versa.

In both cases, GPs in south London and those in West Sussex had no local knowledge of accident and emergency locations and local hospitals.

"They are giving perfectly adequate clinical advice, but have absolutely no knowledge of how to get to A&E and hospitals," said Cllr Walsh, himself a medical doctor.

"How would I be able to give advice to someone in Tooting about which hospital to go to? I wouldn't have the foggiest idea.

"Here in West Sussex, GPs all know where the three main hospitals are. How can patients be satisfied they will get the same standard of care provided so far away by local West Sussex doctors?"

Paul Bond, acting regional director (south coast) for Harmoni, said a single data base was operated which could be tailored to local needs.

Details about opening hours and primary care centres were available to all clinicians.

"This is how you can take calls in one area and pass them to others," he added. "This would include information on locations."

There were also manual folders, giving information about how to get to sites.

The main reason for passing calls from one area to another was load-sharing. It was done if there was higher demand in one area than another.

"We don't want patients hanging on to the phone for an excessively long time," he added.

Mr Bond told the committee: "We believe we create a better and more effective working environment.

"We provide a local service with the advantage of having a single operation where it is needed."



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