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GPs with special interest 'do not ease burden on secondary care'

Claims that GPs with special interests could relieve the

burden on secondary care have been called into question by results from the first study of their effectiveness.

A review of 15 pilot sites suggested GPwSIs may actually be increasing the number of patients waiting for referral in some areas.

The results, presented at a Royal College of Physicians and British Association of Dermatologists conference last month, covered only dermatology but have implications for the whole GPwSI system.

The National Primary and Care Trust Development Programme says the purpose of GPwSIs – set up under the NHS Plan in 2000 – is 'to keep patients out of hospital by developing the roles of GPs'.

But experts suggested GPwSIs may simply be creating new demand by improving services.

Presenting findings from the NHS Modernisation Agency's 'Action on Dermatology' programme, Dr Julia Schofield told the conference that GPwSIs could not solve the dermatology services crisis.

Dr Schofield, a consultant dermatologist at West Hertfordshire NHS Hospitals Trust, said: 'The biggest study worked but we did not see any reduction in referrals – it was meeting an unmet demand. It has improved the service for patients but not impacted on secondary care.'

Andrew Irvine, associate director of Action on Dermatology, said: 'I don't think any of us are too surprised by this.'

Mr Irvine applauded the work of GPwSIs, but said: 'We live in a time of targets and we need to start looking at things in terms of patient experience. If primary care commissioners think a couple of sessions of GPwSI time will solve the problem they are mistaken.'

There are similar problems in ENT, according to Mr David Strachan, an ENT surgeon and adviser to West Yorkshire strategic health authority. 'The GPwSIs are only scraping the surface and there aren't the numbers to make a real impact,' he said.

But Dr Cornelius Crowley, a dermatology GPwSI in west London, said: 'We're certainly an answer – there aren't enough consultants and someone needs to see these patients.'

By Rob Finch

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