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Field: GPs 'should never have given up responsibility for out-of-hours care'

NHS England’s deputy medical director says GPs should ‘never have given up the responsibility for out of hours care’, as the NHS looks at how to ease the pressures on urgent care services.

Posting via his Twitter account, Professor Steve Field, who is deputy national medical director at NHS England and a GP in Birmingham, said that solving the A&E crisis ‘will be complex’, but must involve GPs.

He said: ‘GPs across England go to work each day to do their best and care for our patients - it’s the system - we should never have given up the responsibility for out-of-hours care - causes of A&E crisis are complex - solutions will be too, but must involve general practice.’

RCGP chair Dr Clare Gerada also took to Twitter to join the debate. She said: ‘No correlation btw change in GP OOH contract & rise in AE admissions. No evidence that GPs are ‘too blame’ for crisis in A&E. It’s hard enough being a GP at moment without this.’

‘Rise in AE related to lack of access to social care - NOT GPs and new OOH contract. Important that in these times we don’t use the ‘blame-game”. GPs are working flat out.’

The news comes as an NHS England review is looking at whether GPs should be asked to resume responsibilty for out-of-hours, reversing the 2004 contractual decision to allow GPs to opt out.

Health ministers have attacked the ‘poor provision of primary care’ for rising pressure on A&E departments over the past week, with Dr Dan Poulter saying yesterday that ‘there is no GP out of hours’.

This afternoon, health secretary Jeremy Hunt is due to reiterate comments that A&E attendance was driven up by the formation of the 2004 ‘new GMS’ contract for GPs, referring to the review that NHS England is currently undertaking with regards to emergency and urgent care.

Earlier today Family Doctor Association chair Dr Peter Swinyard said it would be ‘impossible’ for GPs to take on out-of-hours care responsibility again, because of the rise in GP workload pressure. Meanwhile the GPC said it would defend the 2004 contract framework which, according to negotiator Dr Chaand Nagpaul, is ‘remarkably flexible and fit for purpose for the future’.

Readers' comments (18)

  • Steve Field demonstrating once again that he is totally out of touch with the state of General Practice and the fact that giving any more work to GPs would be catastrophic for an already broken system and workforce.

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  • Easy to be wise after the event. Everyone thought the 2004 contract was the bee's knees.
    GPs are now working too hard to cope with out of hours and that is the fault of QOF and other facets of the flawed contract.

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  • This man honestly needs to stop saying words, as he is so far removed from our daily experiences that he might as well be on Mars...

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  • Im oncal for OOHl right now Professor Field; I have been for the past 4 nights, will be tomorrow night, and will be for 5 nights next week. Thats in addition to a 11-12hr day 5 days a week. And Ive done on-call OOH since I qualified as a GP

    How much OOH have you done in the past 5 yrs?

    Thought not.

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  • Prof Field seems increasingly disconnected from what is happening. Does he really expect us to believe that he will be taking any significant part in any OOH. Does he expect us to believe that the governments stance is anything other than an attempt to get OOH covered on the cheap? Someone please give this man his knighthood so he can stop acting like the governments lap dog.

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  • If he's not careful he'll be advocating continuity of care next whilst maintaining his 2 sessions per week.

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  • Maybe we could but qof and commissioning will have to go!

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  • How many hours should GPs work Prof Field? I remember 80 hour weekends - Fri 9am to Mon 5pm with 3-4 hours sleep. Do you wish this again ? Well, then, how many hours , how many patients in a day ?

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  • Out of touch and toadying to the goverment line.Time for him to retire.

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  • The out of hours care was literally forced out of the hands of General Practitioners. As far as I am concerned, I was literally bullied into signing off this cover by the Health Authority, threatened with loss of contract if I did not sign up. It is just not acceptable to blame General Practitioners when the fault lies with the previous government and their advisors.

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