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Allow specialists to work with GPs, says NHS Alliance

Hospital contracts need to be changed to allow specialists to work closer with GPs and base their elderly care services out in the community, says the NHS Alliance.

The call comes after the head of the NHS Commissioning Board said that hospitals were unsuitable for elderly patients.

Dr Michael Dixon, chair of the NHS Alliance, and Dr Donal Hynes, co-vice chair of the NHS Alliance, questioned why specialists were only based in hospitals.

They said: ‘If care of the elderly should predominantly be based in the community, then why are the specialists in this area of care employed by hospitals?

‘The NHS Alliance has long advocated changes in contracts that allow specialists to concentrate, in partnership with their GP generalist colleagues, on their communities rather than being contracted to service the needs of their foundation trust hospital.’

NHS Commissioning Board chief executive Sir David Nicholson told the Independent on Sunday that hospitals were ‘very bad places for old, frail people’.

He said: ‘The nature of our patients is changing – and changing rapidly. If you think about the average general hospital, something like 40% of the patients will have some form of dementia.

‘But our modern hospitals have a highly technological way of operating. They are fast-moving and are organised around getting a diagnosis, referring the patient to the right place and getting treatment. They are very bad places for old, frail people.’

Readers' comments (2)

  • Vinci Ho

    The question is whether you have alternative and 'good' places for these old frail people?
    Specialists working outside hospital need to be supported by appropriate amount of facilities and manpower .

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  • It is not just the specialist contracts that need to changes, General Practice itself needs to rethink and re-organise. We GPs need to focus our attention on those patients on our lists who have the greatest need for generalist primary care - the elderly, frail housebound or house-prone.
    That means we need also to find a different way, one that ise much less doctor dependant, to manage the needs of the worried well, and those with minor self limiting illnesses.

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