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Hunt wants GPs to ‘take back OOH responsibility’

But contract changes just increase pressure on primary care, warns BMA

Louise Prime

Tuesday, 21 May 2013

The health secretary has called for GPs to take responsibility for out-of-hours services for their patients, to help relieve the pressure on hospital A&E departments. But politically motivated changes to the GP contract serve only to increase the pressure on primary care and do nothing to alleviate the crisis in A&E, the BMA warned this afternoon.

Jeremy Hunt denied on The Andrew Marr Show on Sunday that he blamed GPs for the A&E crisis, after Jeremy Vine told him GPs were ‘cheesed off’ at having the finger of blame pointed at them. But the health secretary said he believed the crisis was caused partly by changes to the GP Contract in 2004. He said: “When you remove the responsibility for services at the evenings and weekends from GPs, the services deteriorated and there’s a great loss of public confidence. If you need to speak to a GP out-of-hours, you’ll generally be speaking to someone who’s a long way away from you, who doesn’t know you, can’t see your medical notes.”

Mr Hunt then called for GPs to take responsibility for their patients’ OOH care. He said: “I don’t want to go back to the days of GPs personally being on call at 2 o’clock on a Saturday morning … I think we need to go back to GPs having responsibility for making sure that for the people in their list there is a good service available.”

Leeds GP and deputy chair of the BMA’s GPs’ committee, Dr Richard Vautrey, Tweeted in response to the ongoing debate: “GPs working harder than ever, seeing more patients more often with more complex problems. Longer working could lead to unsafe working … CCGs, OOH, A&E, district nurses & social care can work together & improve care but resource must flow from hospitals”.

Dr Laurence Buckman, chair of the GPC, said the Government was partly to blame for the sharply increased workload in primary care. He said: “Many practices are coping with a fall in funding despite a sharp increase in workload that has been exacerbated by a wave of new targets which divert valuable time away from treating patients. The government is partly to blame for taking GPs away from the front line to deal with these targets.”

Dr Buckman called for much better integration of GP services with out-of-hours care, NHS 111 and emergency hospital services to deal with the complex problem of emergency care. He said: “The government’s own analysis shows that the current pressures have a series of interconnected causes, including reductions in bed numbers and staff shortages in key departments. The botched introduction of NHS 111 has created additional problems for already over-stretched services.

“The BMA believes that much can be done to better integrate GP services with out-of-hours care, NHS 111 and emergency hospital services. Clinical commissioning groups have just taken over responsibility for commissioning out-of-hours care and their pivotal role could find a way forward.”

Mike Farrar, chief executive of the NHS Confederation, agreed this morning that it was useless to keep blaming GPs for the current A&E crisis. He said the crisis was a product of a “perfect storm of different mounting pressures causing our problems – GPs, hospitals, NHS111, the ambulance service and social care … compounded by three years of major structural reforms [and] a lack of honesty about the situation we face”.

Mr Farrar criticised the imbalance of investment in primary, community and social care compared with hospital care, and called for the Government to get right the balance as well as the level of investment.

Picture credit: Brendan Howard / Shutterstock.com

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