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Ensure GPs fully support hospitals over winter pressures

NHS Providers calls for urgent review of how NHS manages winter pressures and is funded

Louise Prime

Friday, 27 January 2017

NHS Improvement and NHS England should “ensure that social care and GPs fully support hospitals and ambulance services” in an urgent review of how the NHS manages winter pressures, NHS Providers insisted this morning. It said this review should also consider how the NHS prepared for this winter, whether or not the NHS should have dedicated winter funding, and the impact of staff shortages.

NHS Providers, which represents NHS acute, ambulance, community and mental health services, argued that as the current approach places most of the burden of winter pressures on trusts, they should be given the opportunity to say what has and hasn’t worked, and what must change. It said a review led by NHS Improvement and NHS England, with input from trusts, should be conducted rapidly so that it can be concluded by this April and its findings made public. This review, it said, should cover at least:

  • How effectively the NHS prepared for this winter, including the role of A&E delivery boards and the impact of cancelling elective operations;
  • Whether the NHS should revert back to receiving specific, dedicated, winter funding;
  • How to ensure social care and GPs fully support hospitals, community and ambulance services, recognising that many of the pressures are beyond the control of NHS trusts;
  • The impact of staff shortages in key roles such as A&E consultants, and related workload pressures.

Chair of the Royal College of GPs Professor Helen Stokes-Lampard has denied that poor GP access is contributing to the pressures currently faced in A&E departments, and added that GPs face year-round pressures, not just during the winter. She said earlier this month: “A patient will always be able to access urgent GP care when they need to, either through our routine service, or the GP out-of-hours service. What we need is more integration between the two, and more information for patients so that they know where to turn for appropriate care when they are sick.

“Blaming GPs for the crisis facing our NHS is not going to help anyone, instead we need to start investing in our health service properly, so that there are adequate resources and clinical staff to deliver the care our patients need and deserve.”

NHS Providers pointed out that, as media coverage has widely reflected, this winter has seen some of the worst performance figures on record against the four-hour target in A&E, with worse than ever delayed discharges, bed occupancy rates consistently above recommended levels and trusts reporting unsustainable workloads on their staff. Its chief executive Chris Hopson said: “The NHS needs a new approach to managing winter pressures. The current situation is unsustainable and the NHS has to do something different next year. The time to start planning for that new approach is now, with a formal review of what needs to change.”

He added: “As it is NHS trusts who bear the burden of the current approach, they should have the chance to set out in a review what has worked for them and what needs to change. The review should therefore include appropriate input from the NHS frontline and expert bodies such as the Royal College of Emergency Medicine.

“The results of the review should be made public so those who use and pay for the NHS can see that the service is seeking to learn from this year’s experience and is adopting a sustainable approach to managing winter pressures.”

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