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Gold, incentives and meh

GP-in-A&E scheme will not be sustainable in the longer term, hospital leaders warn

Hospital bosses have warned that they will not be able to sustain the new 'GP streaming' services in A&E beyond next winter unless the Government puts more cash into the scheme.

NHS Providers, the representative body for trusts, said that the likely continued cost of the scheme will between £500,000 and £1m per hospital, each year - resources which NHS trusts simply do not have to spare.

The Spring Budget pledged £100m to set up the service across England before next winter, but the Treasury has made no mention of ongoing funding for the scheme, which NHS bosses hope will reduce unsustainable pressure on emergency departments.

The report said: 'Many trusts currently do not have this kind of surplus to support this initiative, and it will require funding from commissioners.'

Simon Stevens, chief executive of NHS England, has previously said that every A&E should have a GP streaming service in place ‘by Christmas’ in order ‘to avoid a repeat next winter of this past winter’.

But NHS Providers said even with £100m being allocated this year, this was unlikely to be used ‘quickly enough to make a tangible difference this winter'.

Dr Richard Vautrey, deputy chair of the BMA GP committee, said: ‘The best way to support patients this winter is to invest properly in general practice and community services, as well as developing a much better self-care programme to empower and give confidence to patients.

'Not [by] spending even more money on setting up a service in A&E that simply acts as a magnet to draw in more patients to hospital-based services.’ 

The report also noted the ‘substantial workforce constraints’ limiting trusts’ ability to roll out the GP streaming service ‘when there are already shortages in core primary care services’. 

A Pulse investigation in April found that the NHS would need to find an extra 400 GPs to deliver the plans and Pulse revealed earlier this month that NHS England has instructed hospital trusts not to pay GPs more than £80 per hour.

The NHS Providers report also included a survey of hospital bosses, which found that more than nine out of ten (92%) of them expect the lack of capacity in primary care to impact their hospital’s ability to cope with winter demands.

NHS Providers chief executive Chris Hopson said: ‘Last winter NHS staff responded heroically to extraordinary pressures. But safety and standards of care were compromised.

‘In too many places the NHS was overwhelmed for short periods of time. We must not allow that to happen again.’

The Department of Health has so far allocated £77m out of the pledged £100m funding to 97 trusts for the GP-in-A&E scheme.

It comes as last winter a majority of hospitals consistently broke the national target to treat patients in A&E within four hours.

Readers' comments (18)

  • 1.50 I agree, but unfortunately people frequently do not understand that their ear wax is a low priority. In addition our employers and the media tend to agree with these patients and somehow expect us to provide unlimited access.

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  • But why should the NHS service be entirely free at point of use for every single service then?
    Patients can't offer the services they have risk pooled for i.e. high cost hospital care without an NHS GP referral yet they might well co-pay or pay privately to see a GP if they had access to the NHS high cost services via that private GP they have already paid for in tax.
    You don't need imagination to work this out - much of Europe has co-payment, better objective clinical outcomes and universal coverage.

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  • Classic - hospitals whinge and they want more money
    GPs whinge and they need to work harder !

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  • Yesterday, the local Pharmacist ordered 6 medicines for a patient - 4 of which the patient had not used for 2 years and even had a bad reaction to one of these in the past.
    It was a 'non-paying' patient so she was unruffled when she brought in meds and said she didn't want these. A second patient came in with 2 meds which had been requested by the Pharmacy but not required by the patient - this patient had to pay and was very upset.
    The moral is that Pharmacy is paid per script and our local pharmacy requests all meds if a patient requests just one.
    Unless you have the balls to put a 10p charge on medication, there is going to be continued wastage of billions of pounds of in the NHS.
    All patients, like the first one, who do not pay for medication, do not really care if a medication is given unnecessarily.
    Wake up from your trance colleague Hunt, you've got a goldmine of funds waiting to be released instead of showering cuts on Primary Care.

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  • As others have pointed out, the scheme shouldn't need ongoing funding. If it's not paying for itself it should be scrapped.

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  • I suggest the GPC/BMA actually stand up and say that No GPs will work in A/E as our practices need us more !

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  • Council of Despair

    why does everything have to fall back to issues about money?

    surely if we just all rolled up our sleeves and innovated we could sort this issue out.

    GPs in a&e is something that the public want and the government want. there is no evidence that it will actually reduce demand.

    the public pays our wages and we should do our best to provide the service. we get told all the time that we are paid enough - if we all gave up one night a week for free to staff a&e then this service could be provided.

    sadly selfish GPs want to actually be paid for their work or GPs want to use the time to spend with their family or friends instead of doing something that the government wants.

    this so sad - if only our GP leaders would do some a&e shifts to set good examples then i'm sure others will follow?

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  • it is about money so...ccg do not pay hospital for certain categories of patients and the hospital will solve the problem overnight.

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