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GPs go forth

Hunt: GPs to be held accountable for care round-the-clock as 'named clinicians'

Health secretary Jeremy Hunt has announced that older patients with complex health needs will be assigned a single ‘named clinician’ accountable for their care at all times when they are out of hospital, and has suggested this should be their GP.

Mr Hunt said that the move was intended to drive forward better-integrated, coordinated out-of-hospital care, ensuring ‘patients and relatives have a single point of information and responsibility for their care’.

But the announcement has been met with bemusement by GP leaders, who said that GPs already were responsible for their patients out of hospital.

The announcement marked the the 65th anniversary of the NHS and a major public consultation on a raft of new proposals to ‘refresh’ the NHS Mandate and improve the care of elderly people.

The proposals include developing new recommendations ‘to extend GP choice’, applying the ‘friends and family test’ to practices by the end of 2014 and improving access to primary care through the greater use of technology and ‘rapid walk-in access’.

But in a speech today, Mr Hunt chose to focus on a proposal to have a ‘single, named contact to coordinate an individual’s care’.

He explained: ‘We need to know that there is a clinician accountable for vulnerable older people in the community just as there is a consultant responsible for them in hospital.

‘As a member of the public I would like that to be my GP - but whoever it is they should be named so that patients, families and carers all know where the buck stops.’

NHS England will be asked to have named clinicians for elderly patients with complex health needs in place from April 2014, with the proposals a key plank of the new NHS Mandate for next year. Mr Hunt said that he hoped named clinicians would cover every patient in due course, although he did not offer a timescale for this expansion of the scheme.

The Department of Health said that they would seek views on their proposals to improve the care of older people over the summer and a plan would be produced to implement them with NHS England in the autumn.

A spokesperson said: ‘The final plan will be published in October and will be reflected in the refreshed mandate to NHS England for 2014 to 2015.’

Mr Hunt first floated the ‘named clinician’ proposals at a King’s Fund conference in May and the Government has earmarked £3.8 billion for better care integration and helping older people out of hospital in its recent spending review.

Speaking to Pulse, GPC chair Dr Laurence Buckman said he was ‘puzzled’ by the announcement as every patient already has a named GP.

‘He’s announced it repeatedly, we don’t know what it means. We’re going to be talking to Government officials to find out,’ Dr Buckman said.

‘Every patient already has a named GP. GPs are responsible – I don’t know what he thinks this means.’

RCGP chair Dr Clare Gerada said that the RCGP welcomed the emphasis on GPs’ central role in delivering care for the vulnerable, she had reservations about what the Government is really intending and where the money will be spent.

She said: ‘We’re terribly worried that this will mean £3.8 billion going into the private sector – that it will be a tendering process led by the corporate healthcare providers, the likes of Virgin who will set up integrated care organisations that will employ GPs but will be separate from general practice and will end up being money being siphoned away.’

‘Rather than that we think this should be directly invested in primary care. We have the best integrated care in the world – it’s called the general practice and multidisciplinary care team. If we build on that, if this £3.8 billion comes into primary care, we will deliver the best integrated services for our vulnerable elderly people as well as continue to provide care for everybody else.’

Related images

  • Jeremy Hunt - online
  • Jeremy Hunt - online

Readers' comments (85)

  • round the clokc responsibility.all my patients are elderly. nobody wants to work here. Im writing my resignation as we speak

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  • A ridiculous and shocking idea. How can a single GP be on-call at all times for their nominated patients. This Health Secretary has the brains of an ant.

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  • Community matrons were brought in to look after patients in the community who had complex needs! Patients do not need a named clinician as they already have a GP and a whole practice team set in place to look after their needs. Jeremy Hunt, you are a fool and a clown, you are dabbling with things that you have little knowledge of!

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  • Where is the funding for this coming from? (presumably my bank account)

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  • Half wit!

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  • What the hell does it mean?
    My patients currently have a named clinician- Me.
    Does this mean i am accountable if I take holiday and one of my partners does`nt visit, orr ooh/community team gets it wrong. will I be on call 24 hrs.
    Fag packet idea with no evidence- so "Hunt" can get a soundbite.
    Earlier this week the consultants were targeted, prior to that the hospitals, and as ever we are constantly targeted. I feel like a pawn in a game.
    For god`s sake BMA/RCGp- get some response properly in the press, or please can the DOH/Mr Hunt let us know what the hell this will all mean in practical terms for the people at the coal face, rather than just making ridculous statements with no negotiation!

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  • Does he realize the "buck" does not stop with the named consultant? He/She may be required to be responsible for the overall care but the trust is actually responsible for providing cover for consultant when he is on leave, organizing other clinicians/support staff/infrastructure to ensure an adequate care is given.

    Why does he think the trusts have chairs who over sees the trust? When was the last time we've seen a consultant held accountable for overall failure of the hospital - never!

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  • This man underestimates the rage that he causes. I'd rather spend time locked in solitary confinement 18 hours per day than take round-the clock responsibility. No other medical speciality, bar none is expected to take this level of responsibility. I would not do this for a salary of £500,000 per year. I don't give a ****, I am not bloody well doing this and nobody, and I mean NOBODY is going to make me. Waterboarding could not change my mind......nothing and nobody-and that includes government stooges.

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  • Mr Hunt's true nature is revealeled in these
    romantic untested theories .

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  • I had a patient's daughter tell me yesterday that she was not prepared to be responsible / on call for her father's care 24 hours a day. Her mother is dead, so he is the only dependent she has.
    I have 395 elderly patients on my personal list, as well as a fair number of younger patients with very complex needs. If she can't/ won't do it for one, how on earth can I possibly do it for 395+?
    And she does not have to take the responsibility for rationing/ commissioning/ hospital standards/ practice standards/ financial hit.......

    Good thing I have already resigned.

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