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At the heart of general practice since 1960

GPs need to keep close eye on skill mix plans

Why does the spokesperson for the National Association of GP Co-operatives feel there is a 'huge need for highly-trained and skilled' GPs to provide out-of-hours cover (News, September 13)?

I am involved in the development of paramedic and nurse training and feel they can offer a high-quality service in unscheduled care.

These new practitioners are part of the Department of Health's vision of a highly-skilled multidisciplinary team offering appropriate and seamless care. I strongly urge all sceptics to visit areas (or speak with colleagues) where paramedics and nurses have become established before passing comment. Patients are actually very satisfied and ­ dare I say ­ happier that they did not see the GP.

I am involved with setting up robust training, reviews, guidelines and audit tools for the paramedics who will be called emergency care practitioners (ECPs). Let us not be totally GP centric and remember that others will benefit. In some areas with ECPs, conveyance from home to A&E has dropped by 25 per cent. It has also improved referral pathways and provided more focused care.

This is the only sustainable vision for out-of-hours care.

Dr Daryl Mohammed

Bromley, Kent

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