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GP spots interactions risk in prescribing records

Accident and emergency attendance has jumped by 10 per cent in the past year because patients believe they cannot see a GP out of hours any more, MPs have been told.

Martin Shalley, president of the British Association for Emergency Medicine, told the health select committee the opt-out in the new GP contract had affected patients' view of the care available out of hours.

The increase in A&E attendance compares with an average rise of 1 or 2 per cent in previous years and has been most pronounced during the night and at weekends, he added.

'Many patients I speak to perceive [A&E] is the only place where health care is available,' said Mr Shalley, an A&E consultant at Birmingham Heartlands Hospital.

'I'm not saying it definitely is the GP contract, but I don't know of any other changes that should have affected attendance.'

GPC chair Dr John Chisholm told the committee the changes in out-of-hours care could cause 'alarm' but only if misreported.

GPC negotiator Dr Laurence Buckman disputed that the contract had caused the increase. He said: 'I think most patients have not got a clue there is going to be any change. It is palpable nonsense.'

Mr Shalley's comments came as the Royal College of Nursing warned that nurses with inadequate training and experience were being asked to take over out-of-hours care.

In its submission to the select committee inquiry, the RCN said in one area, nurses with little paediatric training had been asked to assess children to prevent hospital admission.

Dr Mark Reynolds, chair of the National Association of GP Co-operatives, said nurses and paramedics were not ready to take over from GPs yet.

He said: 'There are major possibilities to build an interesting new service, but the transition is going to be tricky and skill mix is not ready yet. PCTs must support GPs and pay them properly.'

By Nerys Hairon

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