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A faulty production line

Chancellor announces £100m towards GP triage in A&E departments

The Government will spend £100m on GP triage in A&E departments, it has announced today.

Laying out the Spring Budget, chancellor Philip Hammond said the funding would become available before next winter.

Mr Hammond also announced an additional £2bn to be spent on social care for the next three years and £325m towards implementing Sustainability and Transformation Plans (STPs).

He told Parliament: 'The social care package I have announced today will help to free up beds by easing discharge of elderly patients.

'That is one of the two big pressures on our hospitals.

'The other is inappropriate A&E attendances by people of all ages.

'Experience has shown that onsite GP triage in A&E departments, can have a significant and positive impact on A&E waiting times.

'I am therefore making a further £100m of capital available immediately for up to 100 new triage projects at English hospitals in time for next winter.'

But BMA chair Dr Mark Porter said: 'The crisis in the NHS doesn’t stop at the hospital door – our A&E’s are struggling because of an overstretched system. Having GPs in A&E won’t reduce admissions – if anything this could have the effect of attracting more patients to hospitals.

'The Government also needs to explain how it will fund and recruit GPs to work on site at hospitals when there already aren’t enough to meet the needs of the public.

'Many are already working in practices with permanent vacancies which they are unable to fill, despite government promises at the last election to recruit 5,000 more doctors into general practice.'

RCGP chair Professor Helen Stokes-Lampard said: 'We feel that the best place for GPs is working with patients in their communities to provide high quality general practice and the money just announced for new triage systems in emergency departments would achieve more if most was spent shoring up general practice so we can deliver more care and services, and in doing so alleviate pressures right across the NHS.'

Dr Onkar Sahota, Labour London Assembly spokesperson for health said the funding announced for social care was 'a drop in the ocean in terms of the increasing need and pressure that councils are under'.

He added: 'As for the chancellor’s commitment to put more GPs into A&Es, he seems to be oblivious that we are already facing a severe shortage of qualified GPs, particularly in London.'

Londonwide LMCs medical director Dr Elliott Singer criticised the budget for providing 'nothing new to GP practices' as 'resource and workforce challenges continue to stretch patient care'.

He added: 'The biggest challenge GPs and their teams in London face is declining morale resulting from increasing workload not matched by increases in workforce. We have seen massively increased demand at the doors of all our general practices as community, social and mental health services which used to support GPs have been dramatically reduced, and a small increase in social care spending goes no way far enough to halt this decline.

The number of GPs in England dropped last year, with the number of GP full-time equivalents including trainees faling to 34,495, down by 96 on September 2015, and this was echoed in a drop in the headcount of GPs.

What does the budget pledge for the NHS?

Accident & Emergency (A&E) capital investment

'Recognising the particular pressures in A&E, the government will provide an additional £100 million to the NHS in England in 2017‑18 for capital investment in A&E departments.

'This will enable Trusts to invest in measures to help manage demand on A&E services and ensure that patients are able to access the most appropriate care as quickly as possible.

'For example, the funding will allow for better assessment of patients when they arrive at A&E and increase the provision of on-site GP facilities.'

Sustainability and Transformation Plans

'The Government recognises the progress that local NHS leaders have made, working collaboratively with partners, to develop local Sustainability and Transformation Plans.

'These local plans are an important part of the NHS’s commitment to deliver more effective services to patients. The government will invest £325 million over the next three years to support the local proposals for capital investment where there is the strongest case to deliver real improvements for patients and to ensure a sustainable financial position for the health service.

'In the autumn, a further round of local proposals will be considered, subject to the same rigorous value for money tests. Investment decisions will also consider whether the local NHS area is playing its part in raising proceeds from unused land, to reinvest in the health service.'

Source: The Treasury

Related images

  • Phillip Hammond - online

Readers' comments (25)

  • It's a right state of affairs when politicians start believing their own spin and propaganda .

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  • Workforce numbers have decreased. A&E deployment an additional demand on a demoralized workforce! Shortsighted and hard to implement

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  • AlanAlmond

    "Roger Boyle | GP Partner/Principal08 Mar 2017 2:55pm

    The big problem is that if it isn't an accident or an emergency then patients (or are they customers?) should not be seen and told to leave the department."

    I completely agree. Inappropriate attenders should be told to take a hike and not pandered to. I keep hearing people try to compair the health service to Tesco, suggesting that the patients are customers and they should get what they want. If I went to a 24 hour Tescos at 2am and told them I wanted someone to scratch my bum I wouldn't be politely asked to "take a seat, one of the till operators will be over shortly with a scratching stick"...I'd be told to bugger off! ...why do we pander to anyone and everyone who turns up at accident and emergency with things that are nothing of the sort? They should be shown the door, not given an instant GP appointment. Guaranteed simply to stoke demand and further confuse an already confused population about where to go to access health care.

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  • The problem with asking inappropriate attenders to take a hike is the hours and hours that you'll have to spend answering complaints that you were neglecting your duties; that they were much more ill than you made out (because you didn't examine them thoroughly enough to find out); that you were professionally negligent; or that you were simply rude. Then the hospital will feel obliged to investigate; and so will the GMC; and your defence subscription will then go up.... far easier to give in and see the patient.
    The bottom line is very simple: if politicians/managers want us to be 'firm' over refusing treatment and reducing inappropriate demand, they have to be similarly firm in backing us up, and refusing to allow us to be blamed, pilloried or referred to a hearing -- never mind named and shamed in the press.
    In the absence of this, forget any question of doctors turning patients away from A&E: it just won't happen.

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  • AlanAlmond

    "John Lockley | Salaried GP08 Mar 2017 3:57pm" are of cause right, but one can always dream.

    The population votes in the politicians, the country is getting the health service it deserves.

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  • You want it now? With fries? That'll be £50 for the consultation (that you didn't need) , £120 for the X-ray (You didn't actually need) and £28,00 for the prescription (Guess what you didn't need that either) but after forking out £198 for a selflimiting condition then the public might start demanding less and actually think about what they actually need...Macdonalds might be 24hrs a day and you can drop in whenever you want.... but you still have to pay to use it.... can you imagine if they gave out free food how busy they would be? If people want a 24hr society where they can just drop in whenever they want.... bill them

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  • A&E to a lot of people now means 'Anything & Everything ' - some of the A&E discharge summaries make me weep/whinge ...recent example ' seen for nappy rash ' - not ' sent away' , but seen .... We need GPs in our surgeries, not in A&E ...this is just rearranging the deckchairs on the Titanic - behaviour.

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  • Spot on John. And all doctors will behave accordingly depending on how the system treats them. It is all more blame, more stick and more work. No emphasis on patient's responsibility.If they are overweight-GP's fault, drink too much-GP's fault. Going to A+E-GP's fault. Poorly funded system leading to complaints-GP's fault and encourage them to complain etc.

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  • Could it be that every punter seen in A+E attracts a tariff payment ?

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  • Wake up! This is a headline to get media attention. They know there are no GPs available to do this new job.The money won't be spent it will go straight back to the Treasury. Objective achieved for no expenditure.

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