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NHS to take care of children away from GPs

By Steve Nowottny

NHS managers are to push ahead with hugely controversial plans to hive off GP care of children to a new breed of community paediatric specialist.

NHS Yorkshire and the Humber – the SHA at the centre of a row over GPs being frozen out from implementation of Lord Darzi's plans for the NHS - has refused to drop proposals for so-called ‘children's GPs'.

The SHA this week became the first in the country to release a final report on how it would be making Lord Darzi's recommendations a reality.

But its proposals to pilot the plans for community paediatrics, despite what it acknowledged had been a strongly negative reaction from GPs, have been condemned as ‘Alice in Wonderland' by GP leaders.

The report also recommends ‘much more skill mixing' to enable GPs to take on more specialised roles, ‘many more' specialist consultations and services in the community, and far wider deployment of urgent care centres alongside A&E.

SHA managers admitted plans for ‘children's GPs' had attracted ‘considerable concern by GPs', and stressed the idea had only been recommended as one option for improving paediatric expertise.

But the report recommended the plan be piloted as one way of driving up standards in paediatrics: ‘This includes strengthening training requirements of GPs in respect of paediatrics, asking a cohort to develop expertise to act as a ‘beacon' with the aim of improving outcomes, or potentially piloting a specific new role of a children's GP.'

Professor Steve Field, RCGP chair, said: ‘We have been concerned about the engagement of the SHA with GPs - and to continue in any way with this idea is like Alice in Wonderland. It's complete and utter nonsense, not good for patients and would go against one of the key roles of the GP in the UK.'

Dr Richard Vautrey, deputy chair of the GPC and a GP in Leeds, said the BMA was also strongly opposed to the plans – although he added the idea appeared to have been ‘downplayed quite considerably'.

‘Whether that actually has any legs I have my doubts,' he said.

GP leaders also expressed doubts over call for increasing skill mixing, with the GPSI role to be developed and an ‘enhanced role' for pharmacists, dentists and optometrists.

Professor Field said: ‘What you don't need are increasing numbers of sub-specialised GPs – you need better generalist skills and quicker access to diagnostic facilities.'

NHS Yorkshire and the Humber's plans for primary care

‘Children's GPs' – SHA admit the plan ‘courted some controversy' but still plans to pilot the role as one of a number of proposals to improve paediatric primary care

Skill-mixing – Call for a ‘team approach' to primary care to free up GPs to increasingly specialise

Care into the community – ‘Many more' specialist consultations and diagnostics services should move into the community, for example through integrated care centres, while federated services should also be developed – but all mention of polyclinics has been dropped

Urgent care – Urgent care centres should be deployed ‘alongside major A&E departments', while support also expressed for a single urgent care telephone number

NHS Yorkshire and Humberside is pushing ahead with plans for 'children's GPs'

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