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CCG calls GPs into 'crisis point' hospital to help assess every patient for discharge

Exclusive: A CCG has asked GPs to help urgently assess every patient on one hospital’s wards to see if they can be discharged, in a bid to ease ‘unusually high’ levels of demand.

An email from Basildon and Brentwood CCG interim chair Dr Anil Chopra, sent to local GPs on Wednesday and obtained by Pulse, said Basildon Hospital had over the past few months ‘struggled to achieve even the minimum waiting times in A&E and this has worsened to crisis point over the past couple of weeks’.

He added: ‘As clinical leaders in primary care we need to step forward and help resolve this and I am seeking your help and support to do this.’

‘We urgently need to assess patients on the wards to see if we can safely discharge them to more appropriate community settings. We need GP volunteers to work with consultant community nurses … and the hospital consultants to assess every patient over the next couple of days – we need one GP tomorrow [Thursday] morning and two Friday morning.’

A spokesperson for Basildon Hospital said: ‘Since before Christmas, we have been coping with unusually high demands on our emergency capacity, and we have already gone on record about the steps we are taking to address this, in order to maintain safe standards for our patients.’

‘We have opened 12 additional beds on site. We are using an additional 40 nursing care beds in the community for patients who can be discharged to continue their assessment or recovery. We have also extended senior medical and management cover seven days a week.’

‘We are working with commissioners to secure the support of GPs and community nurses to speed up assessment and discharge of patients, where it is safe and appropriate.’

Basildon and Brentwood CCG did not respond to requests for comment ahead of publication.

Dr Brian Balmer, chief executive of Essex LMCs, said he was not immediately aware of the CCG email but that it looked ‘very odd’ and raised questions over patient follow-up and whether GPs would be trained and paid for the extra work.

He added: ‘I have never seen this before from a commissioning body and the sense of panic is worrying.’

GPC negotiator Dr Peter Holden said: ‘In more forward thinking parts of the country we have systems to avoid this. This is entirely avoidable if you have a proper hospital discharge policy to start with. Asking GPs to go in and do this now is closing the door after the horse has bolted.’

‘This is what happens when you ask the bean-counting accountants get at it. They forget that an empty bed is not an idle bed. The practice of medicine follows biological variation and you therefore get peaks and troughs.’

Dr Chopra told Pulse: ‘We have been working with local GPs and acute trusts to address the issue of some people attending A&E when they should be attending a more appropriate community service for relatively minor complaints. This could result in somebody with a genuine urgent or emergency care need from receiving the immediate treatment they require.’

‘Our discussions with local GPs and CCGs show that we are in agreement that we must work together with Acute care colleagues and other care services, to ensure that our local population has access to the right care, at the right time, in the right place.’


This story was updated on 31 January at 11:20

Readers' comments (17)

  • Now this is shifting secondary care into primary care, and unpaid as ever. And the GP's get to go into the hospital to the Hospital Trust's work.
    Who are these ***** GP volunteers?

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  • It is increasingly obvious that, in complete contradiction to the direction of travel, we need more investment in hospitals, not less. The concept of care in the community is utter bunkum. There is no care and patients are either abandoned or bounce straight back.

    A properly funded vibrant, confident hospital is urgently needed. I applaud anything that gets GPs out of their ivory palaces to come and see what life is really like at the sharp end and how badly the rhetoric is failing our ill patients

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  • The problem is not so much that we need to invest more in hospital beds. The Acute Trusts over the years have sucked in so much money that there has been a lack of investment in community services to move people out into, thereby blocking acute hospital beds. The real trick is going to be finding the resources to invest in community servies whilst having to pay for the increased work in acute trusts at the same time. From an increasingly limited pot of money, this is going to be a neata trick. If anyone knows how to do this, I'm open to any suggestions!

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  • I laughed at this so much my testicles fell off - well at least I will be able to discharge myself from hospital.

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  • Silly me Anonymous 30 january. I must have it all wrong thinking GP's were at the sharp end.So nice to be re-educated after 32 years experience!

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  • And who will take the blame when a patient is inappropriately discharged, then?

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  • Given that we are often crumbling under our own workloads would the hospital management be kind enough to send out some of the hospital docs to help out with home visits and urgent appointments?

    No, I thought not.

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  • There was a joke going around Twitter a few weeks ago "Q. How many NRA members does it take to change a lightbulb? A. More guns!"
    It sometimes seems that the reflex answer to any issue in health is "More GPs!"
    Whilst this faith in our omnipotence is somewhat touching it may be seen by others as arrogance or even pomosity.
    Hospitals are full of excellent doctors capable of making good assessment of their patients. Could they benefit from more knowledge of community care? Quite possibly. But let's respect them to do their job (and hopefully them, ours) and actually fund some decent and prompt community care.

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  • Where are the Doctors who work in hospital and why can't they do it?
    Who is going to pay for the GP volunteer's locum cover?

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  • Lets not forget those who could be discharged more easily if suitable access were given to allied health professions (OT's, physios etc) and social services. It's likely that lack of availability of these often forgotten and under invested resources can slow discharge processes.

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