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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)

  • This is a very dangerous line to take with the government. There will be no new funding for such activity and there aren't enough doctors to take it on anyway. There frail elderly demographic is growing far to fast for them all to be risk stratified and proactively managed all the time, 24h care is just a pipe dream. 'Self management' just means no real care or reduced access. The real solution is to fund out of hours care appropriately and charge for unnecessary A+E attendance. GPs should charge for appointments like dentists do to cover the rapidly rising demand and the government should abandon all this internal market competition rubbish.

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  • don't the leadership get it?

    no more talking ... it's time for walking !

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  • Who/what determines frail?

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  • 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. Clare I have a few questions, how is throwing more money going to help? It does not make us less tired. What is your plan? are u expecting us to provide cover at the end of surgery for the frail/elderly? Why are u helping the government in its agenda to force OOH back onto us?

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  • It is easy for Dr Gerada to make such comments while she herself works as a private Gp.

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  • I'm sick of Clare Geralda. Soon to be reired from RCGP chair, soon to be London wide master of primary care, currently snuggling up to the government and abandoning those she is meant to represent in favour of expressing her own interest.

    Will BMA stand up and say she no longer represents our view (rememer the recent LMC vote?)? I doubt it and unfortunately this ambitious political GP has sold her profession yet again.

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  • I would have thought the recruitment crisis meant even if there was more funding there would be no GPs to do the work. In which case why would the government put more money in - it does not make sense and appears to be just a plea for more money

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  • It is SO DISSAPOINTING that she has come out with something so obviously stupid and designed to please the government. I thought she was better than this, but Like 'Prof' Field has decided to cosy up and hope that she will be on the New Years Honours list in due course. I feel like Beethoven did with Napoleon when he declared himself Emperor.

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  • 5% of patients ( complex problems ) are 90 % of the work . = 90% of OOH . Will this mean 90 % of OOH funding = NO

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