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GP practices to offer chemotherapy and dialysis, budget statement reveals

The modernised GP practices set to be funded via a £1 billion Treasury windfall will offer chemotherapy and dialysis to patients on site, the Government has announced.

The heavily trailed Autumn Statement, published in full today, has revealed that not only will these practices work with job centres to ‘support people back into the labour market’, but they will also provide advanced care currently only provided in hospitals.

It comes after health secretary Jeremy Hunt revealed on Monday that the practices - set to be finances with funds derived from fines slapped on misbehaving banks - will be expected to cooperate with job centres and social services, which the final statement confirmed.

The document, which is an annual pre-budget announcement based on the latest fiscal forecast for the years ahead, said: ‘[T]he fines collected from the banks that broke the foreign exchange market rules will be used to create a £1 billion fund for advanced care in GP practices in England. Bringing together GPs, nurses and specialists, the fund will pay for the modern premises and technology that will give patients access to advanced care, such as chemotherapy and dialysis, in their local communities.

‘These new primary care facilities will also be encouraged to join up closely with local job centres, social services and other community services, in order to ensure that the NHS is also supporting people back into the labour market.’

The statement clarified that English practices would receive £1bn over four years for premises improvements, with the devolved nations receiving around £200m over the four years, although the Government was unable to guarantee that the devolved government will use it to upgrade GP premises.

Instead, the statement said: ‘The additional funding for the NHS in 2015-16 generates £123 million in additional funding for the Scottish Government, £71m for Wales, and £41m for Northern Ireland. This will make an additional £237 million available for the devolved administrations in 2015-16, which they can spend next year in line with their own priorities.’

In his speech to the House of Commons, chancellor George Osborne said: ‘[I]nstead of returning the foreign exchange fines paid by the banks back to the City, [we] are using that windfall for a £1.2 billion investment in GP services across the UK.’

Meanwhile, a £200 million ‘transformation fund’ which will ‘kick-start’ work on NHS England’s five-year plan will be used to ‘improve the integration of GPs, community services and hospitals’ in England, the document said.

GPC chair Dr Chaand Nagpaul welcomed to funding but said the ‘devil was in the detail’.

He said: ‘It is a step forward that after substantial lobbying from the BMA, the Government has finally acknowledged that GP infrastructure is in dire need of investment. Many GP practices across England are in a declining state and completely unsuitable for the modern demands of 21st century medicine. A recent BMA survey answered by more than half of all practices in England found that four out ten felt that their facilities were struggling to provide even basic care while seven out of ten believed they could not deliver additional services, even though many expressed the desire to do so.

‘This substantial investment, if delivered properly, could help begin to address this problem, but the devil will be in the detail. We need a firm strategy from the Government which commits this funding to be spent specifically on GP premises and not for it to be squandered on other projects. The GPC will work with NHS England to ensure that the investment is used to meet the needs of individual practices and their patients, and not driven by central diktats.’

 

Readers' comments (20)

  • chemotherapy and dialysis?

    So these strings attached are in fact, giant ropes?

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  • Dialysis can be complicated, and isn't something GPs know how to do. Not every patient can dialyze at home; most could crash at any time on the kidney machine. So it's a horrible idea to ask GPs to perform dialysis; they'd be better at neurosurgery, frankly. Far better for the public's health would be to use GPs to prevent the need for dialysis. I published how to prevent 90% of chronic kidney failure in 2002, but so far the NHS has done nothing about my paper.

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  • I'm actually quite looking forward to doing a few hips and knees on the minor ops list , The small ward set aside in the waiting room can also be shared with the midwives to use as a delivery suite .

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  • John Glasspool

    Yes, not really GP practices at all, but as I predicted, new Darzi Centres writ large.

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  • Vinci Ho

    My fee ling is the money is only really for 'big' providers i.e. Federation , APMS provider or social enterprise. Currently existing GMS/PMS practices? Not so sure.....

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  • I'm surprised ICU, scbu, a few acute beds for all specialty, as well as morgue is not included.

    I assume we have to do all this next to the joint venture with job centre that was mentioned earlier on?

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  • David Moskowitz, you were running your paper past a New Labour government that's why - might be worth giving it another shot because surely a privately traded, company called Genomed, based on a few outdated publications and with a tough sounding financial history would be right up Jeremy Hunt's street.

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  • So are the social workers and job centres going to supervise the dialysis and chemotherapy then..?

    Ridiculous. This area unequivocally needs specialist knowledge and yet there is no mention of them in the press release.The current government has no respect for expertise and thinks everything can be reduced to an algorithm administered by untrained personnel. I don't think patients would nor should accept it.

    I agree with David that the funding could be put to far better use. Upgrade GP surgeries so they are purpose-built, clean, clinical environments, that's all we need. By all means run satellite dialysis and chemotherapy units to allow patients to be treated at a convenient location, but run by specialists please, in a safe environment.

    And remember, given the current emphasis on inpatient care, that even consultants can't be in two places at once. If they're 'in the community' whatever that means, they can't be reviewing inpatients. Something has to give

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  • As a GP, I am not trained in dialysis or chemotherapy, and have no plans to be.....ever. If this is going to happen in my surgery, I would expect a consultant nephrologist with his nursing/dialysis team to be present at all times for this to go ahead. Ditto Oncology team for chemo. I would expect to have nothing, I repeat nothing, zilch, nada to do with any of it, prescribing, monitoring, patient feeling unwell/dizzy/rashes, complications and untoward incidents. I'm sure my MDU would definitely not indemnify me to be involved in any way.

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  • We currently provide chemotherapy in the community in collaboration with our local oncology department at our practice. Patients and clinicians love the improved access and the more informal atmosphere. Apart from the initial effort setting it up it can be provided with no extra work for GPs or practice nurses.

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