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Million outpatients to be offloaded on special-interest GPs

Health Secretary Alan Milburn has revealed GPs with special interests will be key to a new Government strategy to offload a million outpatient appointments on to primary and community care over the next few years.

Mr Milburn told the National Association of Primary Care earlier this month he wanted to see more outpatient clinics in primary care, as well as better facilities to enable GPs to conduct more diagnostic services and day surgery.

The Department of Health said the development of GP specialist services would be bankrolled through the enhanced services section of the new contract.

But GPC negotiator Dr Laurence Buckman question-ed whether specialist services would be adequately funded through the contract alone.

Nationally directed enhanc-ed services ­ for which standard fees will be set ­ will only cover violent patients, improved access, childhood vaccinations, flu immunisation and minor surgery.

Dr Buckman said: 'Almost none of the money from the contract is coming for GPs with special interests, apart from those areas. There is £315 million for enhanced services and I imagine some will go to GPs with special interests ­ but not most of it.'

Joint Government-RCGP guidelines for formal GP specialist accreditation in mental heath, sexual health, minor intermediate surgery, child protection, emergency care, diabetes, palliative care, ortho- paedics, dermatology and neurology/epilepsy are due later this month.

Unpublished findings from a survey commissioned by the department suggest there are around 4,000 GPs with a potential special interest. Only 650 GPs had a special interest in October last year ­ a figure the NHS Plan states should increase to 1,000 by 2004.

Mr Milburn hailed the success of specialist GPs in Bradford, where ENT waiting lists have been cut from over a year to a few weeks.

Around 30 GPs in Bradford South and West PCT have special interests. Some are salaried while others have negotiated item-of-service payments for each patient they treat.

PCT chair and former Bradford GP Dr Barbara Hakin said: 'Some of the things our GPs are doing are very sophisticated and I'm not sure whether the [new] GMS contract would allow everything to be contracted.'

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