GPs set to run hospital wards under new ICO pilots
By Nigel Praities
GPs could run hospital wards or see their practices subsumed into acute trusts under a series of radical new pilots of integrated care.
The projects, announced by the Department of Health last week, are set to redraw the barriers between primary and secondary care and may shape future development of services across the NHS.
One scheme in Sunderland will involve GPs becoming employees of the local acute trust to better support patients with long-term conditions.
Ministers have hailed the pilots as offering ‘flexible and seamless' services, but some critics have warned that GPs could end up being subordinated to hospitals.
The £4m pilots in 16 areas of the country will run for two years and then be evaluated for their effect on health outcomes and user satisfaction.
Dr Helen Groom, a GP at Church View Medical Practice in Sunderland running the scheme there, said the practice aimed to have direct access to diagnostic services and consultants conducting clinics at the surgery.
‘They will be taking us over. We'll be employed by the hospital trust, which will remove some of the historical barriers in providing care,' she said.
NHS Cumbria is running a £250,000 scheme for elderly patients, with a federation of 21 GP practices working with community services, specialist nurses and pharmacists.
Dr Hugh Reeve, a local GP and lead for the South Lakeland practice-based commissioning group, said it had already set up two general wards at a local hospital and planned a shared electronic record to be accessed by all professionals.
‘At the moment [patients] feel passed from one organisation to another, with lost information and lots of referrals. The service we will provide will have all that joined up.'
A recent paper said there was potential for integration between primary and secondary care to provide better services for patients, but a risk schemes could result in resources being ‘sucked' into hospitals.
Professor Chris Ham, professor of health policy and management at the University of Birmingham, said schemes would only work if they put patient care above organisation change: ‘The worst thing in the world would be to have hospitals taking over primary care, or primary care behaving aggressively to hospitals.'
Dr James Kingsland, president of the National Association of Primary Care and one of the men responsible for the focus on integrated care in the Darzi review, also warned about the focus on structural change.
‘Incorporating different organisations into one structure is going to be bureaucratic. It is vital it is a partnership, so everyone has equal ownership and an equal say.'
By By Nigel Praities
Npraities@cmpmedica.comGPs could soon be running wards GPs could soon be running wards