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Independents' Day

RCGP says GPs’ place is in their practices, not A&E

RCGP chair Professor Helen Stokes-Lampard has responded to calls for GP surgeries to be co-located in A&E departments, warning that this could come with the danger of encouraging patients to use A&E as their first port of call.

She was responding to a widely reported Press Association survey which showed 61% of GPs and secondary care doctors think that GPs need to be on hand in A&E to deal with patients who turn up inappropriately.

The survey of 500 doctors found that three quarters (75%) believe patients go to A&E without needing to because they think they will be seen faster, and some 60% said expanding GP services was the solution, according to reports.

But Professor Stokes-Lampard argued that 'the best place for GPs is in their surgeries caring for their patients close to their homes in their own communities'.

She said that there was 'the risk that any expansion of programmes using GPs at the front end of hospitals might have the opposite effect to what is intended and encourage patients to use emergency departments as a first port of call for minor illnesses'.

She added: 'GPs are already working flat out and preventing thousands of inappropriate hospital admissions every day... The real solution lies in more investment in general practice and boosting the GP workforce so that we can provide more services in the community closer to people's homes.'

NHS England is already piloting placing GPs in A&E departments as part of eight urgent care 'vanguards' - first announced as part of the NHS Five Year Forward View in 2014.

But a study published last year found that co-locating GPs in urgent care settings increases patient demand, and the set-up costs are far greater than the marginal savings made. The researchers from the University of Sheffield concluded that ‘if you build it, they will come’.

Readers' comments (6)

  • Why do GPs "need to be on hand in A&E to deal with patients who turn up inappropriately" ? Secondary care should have the b***s to turn patients away themselves. There are not enough GPs to cover primary care, without diverting more to do this sort of "dirty work" on behalf of secondary care. Placing GPs in A&E will simply send a message that it's okay to go to A&E for all minor and trivial health issues because you'll be able to see a GP. Utter nonsense.

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  • Publicly funded A and E in Morocco works using bare foot doctors / nurses triaging the masses at the door. The triage process only lets in those deemed really in need. Those left outside either go without care or have to pay. Newly qualified doctors are forced to work in public hospitals for a few years before they can develop their private practices. If more funds are not found in the U.K. I can see it going this way.

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  • AlanAlmond

    GPs in a&e. An proposal symptomatic of a health system that isn't being funded with no one at the helm - heading for the rocks. How about GPs in GP surgeries? Too radical an idea perhaps

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  • Bob Hodges

    As usual, the answer lies somewhere in the middle.

    I work in A&E one session per week. I work 8 sessions in GP. I don't want to work any more sessions in GP.

    The status quo therefore means that the system gets 12.5% extra 'me' capacity available to it if it chooses to pay for it.

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  • They tried to recruit gps locally for a&he, problem was that our workforce crisis is much worse than theirs and got zero uptake

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  • Frankly speaking:

    A&E triage nurses should be able to divert inappropriate patients to 111, the OOH GP or the daytime surgery who can see them on a sit and wait basis. The only currency patient's can offer is their waiting time and having to wait longer is the only deterrent to inappropriate users.

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