This Christmas I did my last out of hours session, ever, a 13-hour daytime shift in an Urgent Care Centre. As I drove home exhausted, I reflected how things had changed since my first GP on call 32 years ago. Back then I was on a one in seven rota –holding the bleep for 24-hours. Day and night, armed with an A to Z and Gladstone bag, I would traipse the estates of South London, struggling to find the right home as the door numbers were never sequential. Most problems related to acute conditions – infections, renal colic, and, given the area I practiced, patients with sickle cell crisis. I had access to an intermediate care facility – low acuity beds. So elderly patients who were ‘just off their feet’ or needing palliative care could easily be admitted for a two-week stay.