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Doctors need US-style pact

GPs should seek closer links with hospital doctors to help to change care pathways through practice-based commissioning, the NHS Confederation is advising.

GPs should seek closer links with hospital doctors to help to change care pathways through practice-based commissioning, the NHS Confederation is advising.

Nigel Edwards, the confederation's director of policy, said closer collaboration between crafts would end the 'cultural' distinction between secondary and primary care medicine.

Adopting a more American style of working, he said, would give patients better care particularly in cardiology, urology, dermatology and paediatrics.

He said: 'In the US they don't recognise the secondary/primary care distinction.

'We know what constitutes good clinical care but we are constrained by the medical politics of the 1930s and 1940s.'

Mr Edwards added: 'Rather than tossing patients over the fence there needs to be a continued dialogue.'

GPs and hospital doctors could draw up a 'super-QOF', that incentivised management of chronic diseases across primary and secondary care, he concluded.

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