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GPs to work in A&Es and mobile care units as NHS England announces eight new 'vanguards'

GPs will be placed in A&E departments and out-of-hours GP services will be integrated with ambulance services and NHS 111 as part of NHS England’s new pilots to reduce urgent and emergency care pressures

The eight ‘vanguard’ areas will also trial greater sharing of patient records with A&E services, and ambulatory care units that can come to people’s home rather than them going to A&E unnecessarily.

The pilot areas these new models will receive support from NHS England centrally in the form of advice and an unspecified amount of money from the £200m transformation fund announced with last year’s Autumn Statement.

The scheme was announced as part of the NHS Five Year Forward View last year, and followed the review into urgent and emergency case by Professor Sir Bruce Keogh, the medical director of NHS England.

NHS England chief executive Simon Stevens said: ‘Starting today, the NHS will begin joining up the often confusing array of A&E, GP out of hours, minor injuries clinics, ambulance services and 111 so that patients know where they can get urgent help easily and effortlessly, seven days a week.’

It comes as NHS England announced its first set of ‘vanguards’ trialling new models of general practices earlier in the year.

The eight urgent and emergency care vanguards

  • Leicester, Leicestershire and Rutland is integrating the work of the ambulance service, NHS 111, out-of-hours GPs including a ‘same-day response team’ including GPs, acute home-visiting and crisis response services, community nursing, older peoples’ assessment unit and urgent care centres.
  • The Barking and Dagenham, Havering and Redbridge in east London is planning on ‘streamlining’ the A&E, walk-in centre, urgent care centre, GPs, pharmacists and out-of-hours services into three points of access, including a digital platform where people can book urgent appointments online; a phone service for advice and appointment booking; and new ambulatory care centres.
  • South Devon and Torbay will open at least two new urgent care centres, prioritising areas of high deprivation. It will also co-locate primary care with A&E and urgent care centres in at least two locations and GP records will be shared with the out-of-hours service.
  • South Nottingham is placing GPs in A&E.
  • The West Yorkshire Urgent and Emergency Care Network will become a mobile treatment service delivering care at people’s homes, with only those needing to go to hospital taken there.
  • Cambridgeshire and Peterborough CCG is planning on hiring ‘GP Fellows’ for its project, a role typically focused on identifying and supporting frail older people.
  • Solihull is launching an urgent care centre at the Heart of England NHS Foundation Trust, including GP out-of-hours and minor injury services.
  • The North East urgent care network is working to integrate services but did not specify any examples.

 

 

Readers' comments (22)

  • The current arrangements are only "confused" because the government have made it that way. A GP in A&E - wow no-one's tried that before....

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  • And the invention of the wheel continues unabated..

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  • "GPs will be placed in A&E departments"

    Excellent plan. Lucky there's not a shortage of GPs to do the existing GP work then!

    Actually, even overlooking this point, it really isn't an excellent plan - in my experience, a GP in A&E typically spends an entire shift seeing trivial minor illness, while earning a higher rate than most of the doctors there who are actually dealing with sick people. It's an extremely cost-inefficient way to staff the service....

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  • 'gp fellows'
    what are those exactly?

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  • "NHS England chief executive Simon Stevens said: ‘Starting today, the NHS will begin joining up the often confusing array of A&E, GP out of hours, minor injuries clinics, ambulance services and 111 so that patients know where they can get urgent help easily and effortlessly, seven days a week.’"
    Ah - so seven days a week urgent help already exists?, Well I never! You could have fooled me...
    Would someone mind telling Agent Hunt this also (as well as teacher-hater Gove)?

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  • "It's an extremely cost-inefficient way to staff the service...."

    I'm not saying I approve but it is probably cost effective for the CCG. The tariff for treating a UTI in A+E locally is about 70 pounds, so two of those and the CCG is quids in.

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  • Bears given wood to poo in....................

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  • Edoardo Cervoni

    I would avoid the fallacy that recruiting more doctors in OOH/A&E would mean better outcomes. This apply also to the 24/7 Consultant on duty. We will continue to prescribe, operate, fill more hospital beds, order more diagnostic tests — in short, spend more money. But the NHS resources (and of our society overall for that matter) would be better directed toward improving efforts to prevent illness and manage chronic ailments like diabetes and heart disease.
    Better coordination of care is also worth investment. Small GPs groups in disconnected offices often provide fragmented treatments, while multispecialty practices integrated with hospitals may well be associated with lower cost and higher quality of care.
    We hardly speak anymore with consultant/hospital colleague.
    I am not alone thinking this way. All these strategies have been shown to improve patient outcomes without adding physicians to the workforce. Instead of training/recruiting more doctors, or make them work longer hours, let's make better use of the ones we already have.
    It seems to me that more doctors than ever are considering retirement and who is familiar with the work/compensation curve, it does not take long to understand that a slightly higher pay shall not be an incentive. In fact, it may do something in the very short run, making indeed things worse as to this shall follow a workforce shortage.
    I hope this helps...

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  • Doesn't mention who is covering the indemnity cover. It's a major disincentive to work out of hours for many at the moment.

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  • No A&E SHOs then!
    At a local OOH service, patients with "less serious illnesses" are diverted to Primary care where a GP has to "clerk" them in for Hospital Reg to review later. Before long, we will shuffling along on the "Consultant" ward round. Now, where is that tourniquet from my PRHO days?!

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