BMA survey finds vast majority of A&E doctors blame GP contract for their rising workload
Out-of-hours move hits A&E
By Christian Duffin
Accident and emergency doctors blame changes to GP out-of-hours services since the new GMS contract for their spiralling workload.
In a BMA survey, 95 per cent of A&E doctors said their workload had increased since January 2004. Of these, 89 per cent said the fact many GPs had given up 24-hour responsibility was a key reason.
Four in 10 of the 476 doctors surveyed said an increase in
direct referrals to A&E by GPs had also contributed to the extra workload.
Martin Shalley, president of the British Association for Emergency Medicine and co-
author of the Emergency Medicine report, said A&E doctors blamed PCTs for shortcomings in out-of-hours services rather than GPs.
He said: 'There was a perception among emergency medical doctors that many PCTs had
not provided adequate out-of-hours cover for their local communities.'
Don MacKechnie, BMA A&E committee chair, said: 'The real issue is one of education. There have been many new services
introduced to treat patients with unscheduled medical problems – walk-in centres, new out-of-hours arrangements and NHS Direct. Everywhere is so different so it is no wonder that there is confusion.'
GPs said the rise in the numbers attending A&E was down to a lack of public information about the availability of primary care out-of-hours services.
GP out-of--hours services mostly worked well with A&E departments, they added.
Dr Prasad Rao, a GP in Stoke-on-Trent with a special interest in out-of-hours care, said the government should fund TV
advertising campaigns advising patients of alternatives to A&E.
He said: 'People should stop blaming GPs. Maybe we should not publicise the fact that waiting times are lower than four hours at some hospitals. It encourages patients to go there – they are not stupid.'
Dr Jeremy Lade, a GP and medical director of WestCall out-of-hours service in Berkshire, said out-of-hours services based in hospitals could help A&E. WestCall is based at Royal Berkshire Hospital, Reading.
Dr Lade said: 'There is no evidence here that increased A&E workloads are down to out-of-hours services. We have an agreement to help A&E when they are busy. We would not
see patients with, say, acute chest pains or fractures. It works well – we send patients to A&E sometimes.'