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GPs could provide 24-hour care for the frail and elderly, says RCGP chair

GPs practices could provide 24-hour care for frail and elderly patients both - in and out of hospital - if given additional funding, the chair of the RCGP has said.

RCGP chair Professor Clare Gerada told the London Assembly’s Health Committee that practices could be tasked with putting together ‘micro teams’ to free up time to deal with patients ‘proactively’.

Professor Gerada has recently been appointed as an appointed clinical chair for primary care transformation in London, charged with improving primary care services alongside London mayor Boris Johnson. She told Pulse that the role will see her tackle a range of ‘thorny’ issues - including the controversial question of whether GPs should retain their independent contractor status.

At a meeting discussing the rising pressures in London’s accident and emergency departments, Professor Gerada argued that investment in primary care-rather than propping up hospitals would help solve the crisis.

Professor Gerada said: [Given the funding] We can do a lot. There’s a whole series of things we can do better. One is we can improve continuity of care for those that require it, particularly the frail and elderly, we can risk stratify and find those patients.

‘I think we need to be providing 24 hour care for those patients in and out of hospital and in and out of hours. We can put together micro teams, to free up the time to deal with those patients proactively.’

She added: ‘We also need to be investing in and encouraging self-management for patients. There are a whole range of things that if we had the time we could use; e-templates, podcasts, we can start targeting those 29-year-old patients who don’t need to be in hospital.

‘We also need to be helping children. On a Monday afternoon A&E is almost like a playgroup, we need to be targeting those with better bespoke surgeries. At the moment we can’t do anything, at the moment we can barely get through a day’s work without being exhausted so that’s what we’d start to do given the money.’

Earlier this year, health secretary Jeremy Hunt said lack of capacity in general practice and out-of-hours services were to blame for rising A&E attendances and overburdened emergency departments, a view which the Labour leader Ed Miliband said he opposed at the party’s conference this week.

Readers' comments (25)

  • "Micro -teams " so small they are invisible to the naked eye.

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  • I thought Mr Hunt has already made it clear that ther is no new money for OOH work,other than that which will be saved by reduced admissions.The conlusion is obvious is it not?

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  • She is already entitled to call herself Lady, so I do not think she is angling for an honour. I would just reiterate that we do not have enough GPs and we are unlikely to be able to recruit enough so piling more and more onerous duties on us is not the answer.

    We are now earning 25% less in real terms that we did in 2004. We are all working much harder. This is not sustainable. This government should be nurturing its' GPs not killing them with stress.

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  • She is looking for work

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  • Money alone will not solve this.... There would have
    To be a radical reduction in day work and a vast increase in staff numbers.
    No one will be expected to work over night
    then come in the next day .Hours worked in the evening will be compensated by later starts in the day
    Will need to recruit more staff to back fill.
    If she believes we will just do our day work then rota a cover doc
    She is misguided and out of touch.

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  • I agree that the frail 5-10% of patient attract the most actual work - so the funding for OOH care should follow them.

    The healthy 90% 'should' attract a lot less work if someone has the will to tell them no when they call at 11pm on a Saturday for a repeat prescription.

    I suggest the frail 10% get NHS OOH care in exchange for the funding given to OOH, can be provided by current OOH provider or GP groups (i dont really care).

    The health 90% are told that they have to wait until they get an appointment on Monday. If they turn up at A+E then someone there needs to grow a spine (pair of ***) and tell them to go away.

    There will be an industry growth of private General Practice at Weekends/ evenings to cover the worried well/ well off and see people who value their work time more than the actual cost of seeing a GP at weekends.

    Can't see it being a vote winner though.

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  • The patients have to go somewhere.If A/Es can't cope then they'll be shunted towards primary care.That's the way it is.

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  • Dr Gerada - two simple questions for you. How many hours in 24 should a GP work, how many in a week. Similar question - how many patients should a GP see in a day, week ? Safely, that is, for patients and doctors.

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  • Anon4.35
    If there is no capacity in primary care
    to cope ,does your argument also extend to this service?
    Or are you in the camp that GPs unlike any other
    Service have unlimited capacity and can work 24/7.

    We to like A and E are st breaking point.

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  • @above
    GPs are portrayed as lazy,greedy and incompetent.The government's propaganda machine has made sure of that.In other words we're to blame for the NHS crisis not the super intelligent and hardworking hospital docs in A/e departments.So all is now left is to make them take on extra work and that is what unilaterally changing contracts is all about.

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