Government rules out new access targets
By Steve Nowottny
The Department of Health has ruled out introducing new targets for access and in-hours care – despite a report it sponsored finding huge variations in standards across the country.
The report, published last month by primary care think tank the Primary Care Foundation and supported by the RCGP and BMA, studied working patterns at almost 150 practices across 5 PCTs. As well as highlighting best practice, it identified a number of areas of concern – including the fact that more than a third of practices have insufficient staff to meet peak demand on Monday mornings.
But speaking at the official launch of the report today, Chris Dowse, head of urgent care and emergency care at the Department of Health, said the department would be encouraging practices to raise their own game rather than imposing new performance management targets.
‘In the past, the Department might have wanted to use that to start commissioning national standards,' she said. ‘But, for now, that's not within the spirit of why we commissioned this work.'
‘It's not about performance management, it's about improvement in general practice. I hope commissioners are going to use it in that spirit.'
Dr David Carson, director of the Primary Care Foundation, said that while many practices had developed a sensible mix of access routes, he had been shocked by some of the extremes.
One practice with a six minute introduction to its telephone system and four options to choose from had turned out to be single-handed practice with just one receptionist, he said, while another ‘profoundly dysfunctional' multi-partner practice had made patients queue outside from 6.30am in order to get a same day appointment.
‘This is all about the 9,000 practices out there – it's not about trying to solve things at a system level,' he said.
GPC chair Dr Laurence Buckman urged PCTs to follow the Department's lead and not to apply the guidance in ‘some simplistic, Lego Brick way'.
But Dr David Jenner, chair of the NHS Alliance's PBC Foundation, said it was ‘odd' that there were targets for out-of-hours but not in-hours urgent care.
‘I think we need to have some hard targets for the assessment of the urgent care patient,' he said.Government rules out new access targets