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GPSI clinics 'can take on half of all consultant work'

GPs with a special interest can transform the landscape of primary care by taking on half of all referrals to hospital, a Department of Health evaluation concludes.

Only one in eight of patients managed in GPSI clinics would require any further hospital care, the report estimates.

But the evaluation, which collated data from two NHS studies of GPSIs, suggested they needed to up their game to deliver the anticipated benefits for patient care.

It found GPSIs were in some instances almost twice as expensive as hospital clinics, and recommended they 'increase throughput' and consider moving to a hospital to cut costs.

The report, published on the NHS Service Delivery and Organisation website, said: 'GPs with some additional training were able to manage one in two patients who would normally be referred to secondary care. [But] hospital consultants are often sceptical about the value for money of GPSI clinics.'

The report was published as the Government unveiled details of its Care Closer to Home demonstration sites, which include pilots of GPSI services in ENT, dermatology and urology.

Professor Chris Salisbury, a GP in Bristol who led one of the two studies included in the new evaluation, said: 'I'm careful not to say things would be the same with every specialty, but within dermatology we thought it was possible to safely manage about half of the patients referred by GPs.'

But Professor Salisbury, professor of primary health care at the University of Bristol, cautioned that forcing GPSIs to increase their throughput might reduce their benefits.

'GPSIs spent longer with patients, so that may be why they were more satisfied. By trying to be more efficient and work faster, you'd probably lose of some of the satisfaction gains.'

Dr Rebecca Rosen, fellow in health policy at the King's Fund, who led the second GPSI study, said: 'It looks like GPSIs are going to need to become more efficient.'

Dr Rosen, a GP in Woolwich, south-east London, said GPSIs would have to form 'innovative new integrated services' if they were to hit the 50 per cent target.

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