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Call to make primary care and A&E co-location easier

Leaders seek changes to allow better primary/secondary care coordination

Adrian O'Dowd

Tuesday, 29 July 2014

Changes are needed to make it easier for GPs to work much more closely with A&E departments, say doctors’ representatives.

A joint call for action has been launched by the College of Emergency Medicine and Urgent Health UK, the federation of social enterprises providing out of hospital urgent care (including out-of-hours primary care).

The two organisations say the current NHS finance system unfairly penalises emergency departments because of the perverse incentives on offer to A&Es hosting “front ending” primary care teams.

The NHS tariff system needs to change, said the organisations which endorsed the co-location of primary care teams with emergency departments.

At present the NHS payment system hampers progress, they said, because it penalises emergency departments when they try to develop effective arrangements with primary care, thus stifling innovation in an important area of patient care.

The organisations are jointly writing to the chief executive of Monitor, Dr David Bennett; the chief financial officer at NHS England, Paul Baumann; and the chief inspector of general practice at the Care Quality Commission, Professor Steve Field, on this issue.

President of the College of Emergency Medicine Dr Clifford Mann said: “The co-location of primary care services with emergency departments is part of the solution to deal with the growing numbers of patients who are presenting to A&E.

“Progress is being hampered by financial barriers in the system which can and should be removed. This is just one area of a tariff system that penalises emergency departments. The tariff system needs reform.

“The college, in our ‘10 Priorities for resolving the crisis in emergency departments’ document, has been promoting change in the tariff system over the past year.”

Chair of Urgent Health UK Dr Simon Abrams said: “It is vital that that the tariff system is reformed in order to resolve this concerning issue and ease the pressure on A&E departments.

“We are keen, in partnership with the College of Emergency Medicine, to offer our continued assistance to health leaders and regulators to ensure progress is made as soon as possible.”

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