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A faulty production line

GPs should treat all unplanned admissions as 'significant events', says Labour review

GPs will have to treat all unplanned hospital admissions as ‘significant events’ under proposals being put forward by Labour’s healthcare commission.

The controversial suggestion forms part of recommendations developed for Labour’s shadow health team by Sir John Oldham, a GP in Glossop and the former efficiency tsar at the Department of Health.

The proposals focus on integrating the delivery of care in the community to avoid unnecessary admissions to hospital, which are similar to current developments being proposed by the Government.

But it goes further in suggesting that GPs should evaluate each unplanned admission to hospital, including readmissions, as a adverse events which they should learn to avoid in future.

The report read: ‘The NHS must also recognise the role of specialist expertise beyond the confines of hospital buildings; there is a need to deinstitutionalise our basic concept of health care delivery for whole person care to be achieved.’

‘This alignment to specialist knowledge with primary and community care must form a central part of whole person care, allowing for a greater focus of that specialist expertise on keeping the population well in their own homes rather than treating people once they require acute care. As part of achieving this we believe that GPs should view all unscheduled admissions, including readmissions, to be Significant Adverse Events, which need to be reviewed within a framework of continuous quality improvement.’

The review was set up in May last year to inform Labour’s health policies ahead of next year’s election and also recommends there should not be another major reorganisation of the NHS until 2020 at the earliest.

It recommends a ‘National Conversation’ is set up to outline legislative changes merging of health and social care budgets that would come into effect by 2020.

It said: ‘In our view, a new compact needs to be agreed with the citizens of the country. We argue that the vehicle to achieve this is an independent National Conversation looking at health and social care together, to be completed within 12 months of the next general election and with legislation enacted thereafter to enable implementation from 2020 onwards.’

In the interim, it recommends CCGs become more involved in primary care commissioning, something that NHS England has said it is already looking at.

It goes on to recommend that a form of scrutiny committee is set up, similar to the recommendations in the GPC’s plans for the future of general practice.

The report said: ‘While we believe that primary care should remain formally commissioned by NHS England, local arrangements should be developed to ensure the alignment of the commissioning for care. The nature of these arrangements are best determined locally, but may involve the development of joint committees between NHS England local area teams, CCGs, local authority commissioners and health and wellbeing boards to provide local scrutiny and oversight.’

‘Fundamentally, the commissioning of primary care needs to be aligned with local population needs in a commissioning system where health and social care are aligned and where “sense of place” determines the commissioning of services. We believe that these arrangements should be shaped in full to carry out this role from 2017.’

It added that financial incentives also need to be locally aligned, something which NHS England is planning to look at in an upcoming review of incentives.

The report said: ‘We also believe that financial incentives for GPs must be aligned with the outcomes required within the health and wellbeing board’s local collective commissioning plan.’





Readers' comments (31)

  • utter madness

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  • Really? This doesn't make logical sense. Unplanned admissions are part of my routine working week. Some of my patients are chronically ill and sometimes they need to go in for things like CT scans, emergency surgery and IV antibiotics that only a hospital can provide. There is nothing abnormal about this and it is wrong to treat it as such. The tone of this policy is that it's our fault that human beings are mortal but the reality is that the government are just shirking their responsibility to provide enough hospital beds and appropriately resourced community care. Repealing the 2012 Health and Social Care Act is a good idea though!

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  • Let common sense prevail

    The department of health should treat it as a significant event every time they are struggling to find a bed for a sick patient who needs hospital care.

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  • Bast*rd patients getting ill without my consent - At the next election I am voting for the party with the prettiest logo as they are all stupid.

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  • I think the police should write a significant report every time a criminal commits a crime unexpectedly.
    The AA should report to the government every time a car breaks down.
    etc etc

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  • no surprises here - it just gets better and better.

    I'm just waiting for someone to come up with a credible exit strategy for the profession.

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  • Took Early Retirement

    Morons- all of them.

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  • Just when you thought it could not get any worse, what chance have we got as a profession when one of our own GP colleagues is suggesting such utter nonsense, maybe I should ascend the ivory tower and pontificate rather than seeing patients like I was trained to do.

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  • There won't be any GPs in the future. The NHS is now going out of control. All we see is theory and planing. No body treats patients. Just sitting in the office and planning. Trying to reduce the hospital services which we never heard of this. Hospitals should not be destroyed. Meeting after meeting for waht? Experienced clinicians are deditated by young doctors. That's all I can see. I would say crazy clinicians are get involved with patient care.

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  • I would suggest closing every Monday so we can have our unplanned admissions significant event reviews. Any patients that day will have to be redirected to A+E.

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