Any Qualified Provider (AQP) is now a reality that will impact on all GPs in one way or another. More of us, either as a single practice or working together with others, will use AQP to establish new community based services. The best of these will complement and work with local hospitals and specialists.
However as AQP grows it will undoubtedly draw in more private sector providers not least because the current qualification process for AQP can favour large commercial companies who have the resources to plough through the bureaucratic application procedure and take the financial risk of investing in a service which is dependent on securing enough referrals to make it viable.
It’s risky, but at a time when the Government are cutting our resources, more of us will need to rise to the challenge to protect our practices and the services we offer to our patients.
However the consequence impacts on every GP. Referring patients in this increasingly fragmented system becomes more complex and more time consuming. There is a naïve belief that GPs should operate like a travel agent, with patients serenely picking their desired destination in the same way they book a hotel or a weekend away. GPs will be asked to help these customers (formerly called “patients”), but instead of simplicity at the click of a button they will increasingly be tour guides in a complex labyrinth of health care providers.
We don’t have the time to explain
This will take a huge amount of time to manage in practise, and time is something most GPs no longer have. As our waiting rooms bulge with people needing to be seen it’s not too hard to imagine how annoyed many of them will become as we increasingly run late while donning our new role as a tour guide.
Leaving aside the workload issues, there is also a quality control problem as well. It is easy and good practice to advise our patients about the service offered by our local hospitals and local GP providers. They are usually people we know. But as AQP takes hold, and the NHS becomes fragmented there is little chance that any GP will have the detailed knowledge necessary to provide good advice without us too doing internet searches with our patients. And while we do that, other patients are impatiently looking at the waiting room clock.
GPs will, as always, continue to provide the best service we can. But making us a tour guide for a complicated process is not going to make for a comfortable journey either for GPs, or more importantly, for patients.
Dr Richard Vautrey is the deputy chair of the GPC and a GP in Leeds.
