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Patients will be able to see a GP in 'every A&E' by next winter, says NHS boss

Every A&E department in the country will have to ensure it has a GP triage service in place before next winter, NHS England's chief executive has said.

A letter from Simon Stevens to trusts today clarified that 'every hospital' should implement a 'comprehensive front-door streaming model by October 2017', which he told MPs would require a GP in every A&E.

This followed chancellor Phil Hammond's Budget, which announced yesterday that £100m will be used to support 100 projects to place GPs in A&E departments.

The announcements come as part of a major crackdown by the Government following a winter where a majority of hospitals have consistently broken the target of seeing all patients within four hours.

Mr Stevens and NHS Improvement chief executive Jim Mackey wrote to all CCGs and hospital trusts this morning to let them 'know about the action now needed to turnaround A&E performance in 2017', adding that the NHS has to make 'concrete changes' in order 'to avoid a repeat next winter of this past winter'.

It set out that every hospital should implement 'a comprehensive front-door streaming model by October 2017, so that A&E departments are free to care for the most urgent patients'.

Mr Stevens told the Public Accounts Committee meeting this morning that 'the £100 million capital is to make sure A&E departments can make the space available for GP steaming, the model that has been successfully adopted in places like Luton and Dunstable hospital, one of our top performing A&E departments in the country and have these in place by Christmas'.

'We want all hospitals to have comprehensive front door streaming with GPs by next Christmas,' he added.

The £100m announced yesterday is 'a contribution to that', he said, adding: 'This is probably going to be 50 to 100 hospitals which need a bit of remedial work or extra capacity creation.'

Mr Stevens acknowledged that 'this is only part of the solution' and that 'other things need to change as well'.

He said that 'possibly the most important' would be using the £2bn of extra social care support announced in yesterday's budget - £1bn of which is being made available this year - 'to ensure that elderly and frail people are able to leave hospital'.

He said: 'If we can free up to 2,000-3,000 hospital beds, that’s the equivalent of opening five new hospitals.'

The letter to trusts and CCGs said it was 'vital that, together with our partners in local government, we ensure that the extra £1bn the Chancellor has made available for social care is in part used to free-up in the region of 2,000-3,000 acute hospital beds'.

It added: 'We would ask that you immediately now engage with the senior leadership of your local adult social care departments to discuss how those patients stuck in hospital needing home care or care home places can access those services.'

At the same time, speaking at the Reform Health Conference this morning, health secretary Jeremy Hunt said that 'A&E departments and their performance is a fundamental matter of patient safety' and that it was therefore 'absolutely essential that we do get back to the 95% target'.

He said: 'I expect the NHS to return to that target during the course of the next calendar year and make very tangible progress towards that target through this year.'

In the speech, he welcomed the £100m 'into the GP triaging systems, stream system, which we've seen works spectacularly well'.

Related images

  • A&E entrance - emergency - emergency - online


Readers' comments (28)

  • Azeem Majeed

    How about patients being able to see a GP in every general practice in England by next winter?

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  • Outcome- Go back to see your own GP!!

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  • Vinci Ho

    Not sure it is good or bad.
    Is this the first time GP is specifically targeted in a Budget's announcement about NHS by a Chancellor ?

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  • Vinci Ho

    What are going to call these GPs?
    GPs with extended interest (special interest previously) in Accident and Emergency OR
    A/E SHO with extended interest in general practice??

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  • Dear Vinci, they will be called gofer proxies.

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  • Not this GP they won't. I work enough. And now that nice Hammond chap is kicking me in the perineum with his NIC "improvements" there's absolutely no incentive to work harder. I'm off for a walk in this gorgeous spring sunshine.

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  • Dear All,
    Is a "front door streaming service" classed as being in A/E or out? If its in A/E then this will do nothing. If its out of A/E, i.e. the patient is allowed to be "streamed" to somewhere else; i.e. eff off this isn't important enough for you to be seen here today, then perhaps this might work. Its Mr Hunt's way of getting round the absolute nonsense of the 4 hr A/E must deal with anything the patient brings including johnny who's had a sore throat for 9 minutes target.

    Lets tease out that question first.

    Regards
    Paul C

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  • Not interested 9 sessions of the ball breaking soul destroying nonsense every week is more than enough for my sanity,my indemnifier and my soul to put up with.You could not pay me enough to go anywhere near this s**tfest with a very long pole.Goodnight Ive got some alcohol in the fridge with my name on it to kill the pain and enhamnce my resilience to todays stint on the frontline, goodnight comrades..

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  • Anonymous Locum GP

    questions -

    1. where are we going to get these GPs from as we are short of GPs in practice?

    2. who will cover their indemnity? - if they are triaging A&E work then that role may be viewed as high risk from the defence body perspective so expect high premiums.

    3. what hours will they be available i.e. 24/7 ? then again where do you get these GPs from?

    3. how much will they be paid? if you are going to offer 80k for a 24/7 rota with exorbitant defence fees then you will get no one. if you are offering 100k with indemnity then you could afford 2-3 A&E SHOs with that so it doesn't make sense poaching 'expensive' senior staff relative to cheaper junior doctors.

    please ask questions as it's clear no initiative in that last few years has ever been thought through and this looks like another one.

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  • They have not got a clue. Clueless mandarins in the DOH

    Quite apart from getting anyone wanting to do this. The indemnity issue will be insurmountable

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