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Gold, incentives and meh

GP leaders call for the return of intermediary care centres

GP leaders have argued for the return of intermediary care centres, to allow GPs to admit patients for simple interventions and help curb rising A&E use.

Following a meeting of the London Assembly’s health committee, Dr Onkar Sahota, the committee’s chair and a GP in Hanwell, west London, said that intermediary care centres could ease the pressure on hospitals.

He said: ‘[What we need is] Intermediary beds, a step down from the hospitals, where GPs can admit patients for short sharp interventions.’

He added that the whole system needed to be reconfigured with more of the overall NHS budget allocated to primary care, as any short term  would only act like a ‘sticking plaster’.

He said: ‘Whatever proposed in the winter months will be a sticking plaster. We need to look at structurally how healthcare is structure in London and in the wider NHS.’

Speaking at the health committee meeting, RCGP chair Professor Clare Gerada also called for the return of ‘step-down services’ such  as intermediary care centres.

She said: ‘When I started in general practice there was something called the Tomlinson review. The Tomlinson review recommended intermediary care centers, intermediary care hospitals. And we had two in Lambeth, we’ve now got one because it was shut.

‘What they were was low threshold, GP-run services. We had access to beds, we had access to diagnostics, we could admit people for the day just to have IV antibiotics, for example, assess people for the day. It was co-located with physiotherapy, occupational therapy, dentistry, social  workers and general practice. And then they were all shut and we lost a valuable report, able to deal with not hyper acute but certainly acute elderly patients.’

The RCGP chair also said at the meeting that GPs practices could provide 24-hour care for frail and elderly patients both - in and out of hospital - if given additional funding.


Readers' comments (12)

  • Thank goodness for common sense. Rather than banging the government's agenda of a micromanaged salaried workforce which would be a disaster, Dr Gerada is now finally banging the drum of our common sense agenda. Ok, she will miss out on a "Dame" for this but doing the right thing is what counts in the end.

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  • Excellent idea, however it is not a cheap solution even if it is the right solution. The problem is convincing anyone to invest in intermediate care beds and community hospitals. In our area, Ludlow, with a high % elderly, we were about to start building a brand new health facility with the ability to have intermediate care facilities. This project took 6 years in planning and only months to cancel by our shortsighted CCG dominated by urban GPs, who do not feel that these rural community facilities were worth investing in and decided to can the whole thing in order to make savings.

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  • Won't happen,no money,no staff in market for these jobs and last but no least no good will after way we have been treated by the "great and the good".

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  • As a UK GP who now works in regional australia, we have a local hospital with 40 beds to which we admit patients with cellulitis/pneumonia/COPD/urinary sepsis/small bowel obstruction etc - anything that we feel we can treat conservatively. It helps you keep up an extended range of skills such as IVs, catheters, ABGs - even chest drains if you want to. We get paid fee-for-service for consults and procedures. We also have a teaching hospital 1 hour away if it all gets too hard. I can't see the NHS re-inventing/re-opening community hospitals for GP use, just to take the pressure off A+Es.

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  • I have been saying this for years. Excellent idea and I just wonder whether it might just make the job more interesting, I would love to be able to admit locally to a bed and provide some simple intervention IV antibiotics or a few days of nursing care which is all a lot of the elderly need rather than a full blown hospital admission (and it has to be much cheaper surely?)

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  • In my GP training practices 25yrs ago both had access to community beds. I felt like a whole doctor providing a whole service rather that the button pushing robot I am today.

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  • We do it already, we admit, take care of our elderly and do the whole lot, we give a fantastic service BUT our new community hospital building which was going to have even better facilities has just got canned due to cost savings. The bottom line is that acute care always takes priority and shortsightedness, lack of investment in rural areas and lack of vision is the order of the day at the moment in Shropshire. Am I annoyed.....absolutely

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  • Really good idea- unfortunately:
    a- no money
    b- our local ones have been shut down
    c- the Government would see it us just lining our pockets
    d-they are not listening anyhow.

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  • Hooray for common sense - now please someone in authority take note and drive this thing forward!...

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  • Had this in Brighton. Problem was, hospital post-take ward rounds, all beds filled with step-down discharges by lunchtime.
    GP does visit-no beds ever available!!
    Improved local trust's discharge figures though!!

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