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Consultants voice fears over GP post-op checks

By Katherine Haywood

Government plans met with concern over continuity of patient care

Consultants have warned that plans to transfer some post-operative checks to GPs will compromise continuity of patient care and may delay additional treatment.

Plans for GPs to undertake up to three-quarters of a million post-operative checks, including those for varicose veins, hernias and joint replacements, were outlined by primary care tsar Dr David Colin-Thome earlier this month.

Dr Jonathan Fielden, chair of the BMA's consultant committee, said the checks were an essential part of a surgeon's responsibility and that cost-cutting rather than improving patient care lay at the heart of the proposals.

'Clearly there are concerns that cutting out patient contacts is being driven by financial considerations and that sometimes important policy decisions are being made by non-medics,' he said.

Many consultants are concerned GPs would not have sufficient training to treat some problems and would have to refer patients back, delaying care.

One orthopaedic surgeon, who did not want to be named, said that a trial in the north-west where GPs took on checks had been 'a disaster'.

'A lot of those patients have been reinstated because the GP felt unable to deal adequately with the patient in the long term,' he said.

Mr Tajesh Bagga, an orthopaedic consultant at Diana Princess of Wales Hospital, Grimsby, asked: 'If there is a post-operative problem, will the GP be able to look after the patient or will they need to send the patient back through the Choose and Book system?'

Other consultants observed that consultants and patients both benefited from the checks. Mr Adnan Faraj, an orthopaedic consultant at Airedale General Hospital in Keighley, Yorkshire, said patients found follow-up with the surgeon 'psychologically reassuring'.

And Mr Glyn Evans, an orthopaedic consultant at the London Knee Clinic, said the checks were essential to a consultant's continuing development.

'Only by "taking out a patients stitches" do you get the feedback that enables you to hone your standards and go on improving,' he said.

Mr Roger Checketts, an orthopaedic surgeon at BUPA Washington Hospital, Tyne and Wear, said: 'Surgeons are not just technicians nor are patients mere objects to get through the system, as the Department of Health thinks.'

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