PATIENTS in the North-East are likely to be the first to get home visits from nurses rather than GPs as part of a radical shake-up.

Five primary care trusts serving 670,000 patients from Redcar to Darlington have invited private health firm Primecare to provide out-of-hours services from next April.

This follows a national agreement with GPs which means the vast majority will no longer provide medical care after their surgery closes. Instead the local primary care trust is responsible for out-of-hours services.

The agreement struck between Primecare and the North-East PCT group is the largest deal of its kind so far in England.

It means that the out-of-hours service for much of Teesside and South Durham could be taken out of the hands of local doctors eight months ahead of any other part of the country.

Apart from replacing doctors with nurses for some home visits the other novel ingredient is the plan to provide transport for patients who need to travel to and from out-of-hours treatment centres.

The new service will also give paramedics and pharmacists a new role.

Dr Mike Sadler, spokesman for the Hertfordshire-based healthcare company, "Right now this is the biggest single contract we have signed. It is a big vote of confidence in our ability to ensure out-of-hours standards are met."

Dr Sadler confirmed that nurses would play a more prominent role in providing out-of-hours services, taking phone calls from patients and passing them on to a doctor if necessary.

Patients taken to an out-of-hours urgent care centre could also be seen by a nurse rather than a doctor under the new arrangements.

But Dr Sadler stressed that whenever it became clear that medical input was needed a doctor would be on hand to talk to or see a patient.

Colin McLeod, chief executive of Middlesbrough PCT, who has been leading the project on behalf of Langbaurgh, North Tees, Hartlepool and Darlington PCTs, said: "I will guarantee that if a patient needs to see a doctor, they will see a doctor. Patient safety will not be compromised." The new arrangement will also see paramedics being used to make home calls and queries about medication being handled by pharmacists.

It is expected that patient calls will eventually be handled by a single centre covering the whole area. Primecare already provides out-of-hours coverage for many Teesside GPs.