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Health secretary announces 'one-stop' plan to revolutionise role of GPs

Health secretary Jeremy Hunt has announced a new programme aimed at moving more patient services to GP practices from hospital.

Mr Hunt said that under his ‘GP one-stop programme’, the NHS will be going through ‘condition by condition’ to see which can be handled in general practice rather than secondary care going forward.

Mr Hunt said that the NHS has to ’get back to basics and think how many issues and problems could actually be solved with a visit to a general practice’ rather than ‘sending someone to the back of another queue’.

Speaking at the Best Practice conference in Birmingham today, he said: ’I think it is quite sobering to note that the entire outpatient budget for hospitals is around the same as the entire general practice budget.

’[But] I think as far as patients are concerned they would much prefer it if a lot of those problems were sorted out inside general practice.’

Mr Hunt said his plan would include a range of conditions, such as for example diabetes.

He said: ’So you will be hearing more about what I am calling “the GP one-stop programme”, looking at areas like diabetes, end-stage renal, and many others.

’We are going to go through, situation by situation, condition by condition, and ask what barriers we can remove centrally to allow more of this work to happen in general practice.’

He admitted that this meant asking GPs to ‘do more work’ but said that they would be ‘paid for doing that’ and argued that it would also ‘make life more rewarding for doctors’.

And, aside from being more satisfying for GPs, Mr Hunt said the model will allow patients to be seen more quickly.

He said: ’It’s not just that it’s better for patients, because they’ll get the care they need more quickly, but also its part of making the process of making life more rewarding for doctors, because it think the last thing a doctor wants to do is send someone home without having sorted out the problem.’

But he added that the Department of Health was looking at how it would fund this shift in workload.

He said: ‘That means looking at payment systems.

’Because we are asking GPs and practices to do more work, they need to be paid for doing that. It also means removing some of the inflexibilities.’

The news comes as NHS England is in the process of developing a new voluntary GP contract for large-scale multidisciplinary GP practices with 30,000 or more patients, which aims for practices to employ a wider range of healthcare staff.

But it also comes as the GPC has been successful in convincing NHS leaders to amend hospital contracts to stop ‘workload dump’ from secondary care colleagues, amid unprecedented pressure on GP practices.

GPC deputy chair Dr Richard Vautrey said: ’

Many practices and GPs already do this, caring for the vast majority of their diabetic patients. However this shifted work is not matched and supported by shifted resources and moving funding to make such services sustainable is what is really needed.’

Readers' comments (57)

  • ’We are going to go through, situation by situation, condition by condition, and ask what barriers we can remove centrally to allow more of this work to happen in general practice.’

    But he added that the Department of Health was looking at how it would fund this shift in workload.

    He said: ‘That means looking at payment systems.

    ’Because we are asking GPs and practices to do more work, they need to be paid for doing that. It also means removing some of the inflexibilities.’

    OK, so QOF will be removed (with expectation that we will still carry out all this 'good practice'), along with significant funding, and we will have to re-earn it by jumping through yet more hoops...

    Oh joy.

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  • 1. Not enough GP's to do current definition of General Practice.
    2. Not possible for a doctor to be a specialist and a general practitioner, as they are both roles that require years of training and a full time commitment to keep up to date.A GP with a special interest in a subject is one who knows more than the average GP , but unlikey to be a consultant level.
    3.Is he trying to turn GPs into consultants , ones that can see patients in 10 minutes with no nursing staff? If so he needs to say and so we know to start a different specialist training. Or more likley retire.

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  • I want to be a GP not a specialist,being a specialist would be very very dull.

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  • Hunt has made a suggestion here which merits investigation but doctors like everyone else require to be paid for what they do and training updates may be required and paid for in some doctors' cases so that they can actually perform the extended services envisaged. Keeping patients out of Hospital when possible may also reduce the incidence of Hospital Aquired Infections. Hospital treatment is of course very expensive and has to be restricted to patients whose illnesses and conditions must be treated in Hospital. But one cannot have any good clinical services without them being paid for and the Government is clearly already underfunding the NHS because we are not training enough doctors and waiting times are again increasing. Having a one stop shop will require additional resources because it may require surgery buildings to be extended and additional nursing staff plus additional equipment costs. Hunt should always be confronted with the costs of his proposals before publicising them. We won't get one stop shops without considerable investment.

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  • Talk about failing to grasp the basics!
    THERE ARE NOT ENOUGH GP's or PRACTICE NURSES OUT THERE TO COPE WITH THE CURRENT WORKLOAD and those of us reading this will be trying to get out of GP land ASAP.

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  • this is one area that everyone here is getting wrong.

    This is what GPC and RCGP should be doing:

    take the bull by the horns here and make a grab to control medical training in relevant areas.

    I.e if the plan is to move Dermatology, pain clinics, gastroscopy(etc) into community then take control of the training structures. there is huge potential to really enhance the purely medical aspect of General practice.

    I spent sev years trying to do this but HEE wouldn't even consider this.

    No-one can be asked to deal with issues beyond their training and skill - so the noise about dumping work can easily be bounced back. But if GP's take control of several traditional hospital roles and the training infrastructure then it cold strengthen general practice

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  • What we all acknowledge is that General Practice in its current model is not sustainable, nor is that of Secondary Care.
    We need to redefine the clinical paradigm so that we can have the resources(human,technical,financial etc)to enable us to deliver this.
    Infantile whining about "evil Tory plot" gets us nowhere. Our patients deserve better.
    Lets endorse positive changes for the future and liberate ourselves from the Dr Finlay "cottage industry"mindset.

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  • ROBIN JACKSON What we all acknowledge is that General Practice in its current model is not sustainable

    Actually there is no evidence that is true.

    the drive for federation models is ideological and carries no evidence.The Dartmouth group which is driving the 5yr forward view have no experience driving change at this scale, and very understanding of UK GP.

    there is ample evidence that UK primary care can work well( and is working well compared to international standards) and the pressures on it are from external factors ( lack of work force planning, change in demographics, indemnity etc).


    Nothing is sustainable if you choose to define it that way.

    UK GP is incredibly efficient and productive - it is highly likely the MCPs will destroy that

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  • I'm dismayed at the scepticism of these posts! This is doable with all the FREE time we are wasting ....BUT It may involve self catheterisation, nappies IV drip and a whip.....

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  • complex heart failure case. heart failure nurse wants to add in yet another poison. wants me to prescribe it but she'will take responsibility'.
    I advised her to go and chat with the cardiologist at the trust that employs her.

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