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Independents' Day

Patients being sent to GPs for post-op checks

By Cato Pedder

Hospitals are beginning to shift responsibility for postoperative checks to GPs following recommendations from the primary care tsar earlier this year.

The revelation comes amid growing concern over the Government's aggressive policy of moving care from hospitals to GPs. New figures show emergency readmission rates to hospital are rising, suggesting patients are being discharged too early.

Barnet LMC in north London has advised GPs to refuse to do postoperative checks and suture removal after increasing numbers of discharged patients were told to see their GP.

The move by local hospitals comes just a few months after a report by primary care tsar Dr David Colin-Thome advised trusts to shift responsibility for postop checks to GPs to free up resources. He said routine six-week postoperative checks made no economic sense and suggested patients could 'pop in' to see their GP instead.

GPs reacted angrily to his suggestions after the Department of Health said no nationally agreed funds would be attached, and now Barnet LMC has become the first to boycott the work.

LMC chair Dr John Brett said the work was 'unacceptable' because GPs did not have the resources to deal with the extra consultations and were not being paid for it. He said each GP might have up to 500 patients a year discharged from hospital and having to do postoperative checks would put 'intolerable pressure' on them.

'We have been sending patients back to outpatient clinics, and it seems to have stopped happening. We don't know if it was being put into practice as a matter of trust policy or whether it was just exuberance on the part of junior staff.'

The GPC has warned GPs will not do the work unless it is funded, and GPC member Dr Chaand Nagpaul, a GP in Stanmore, Middlesex, said: 'GPs collectively need to pre-empt this by insisting it is not a core GP service.'

Fears that primary care is being overloaded with work have been further fuelled by NHS Information Centre figures showing the number of people readmitted to hospital after dis- charge has risen 22 per cent since 1998.

Dr Nagpaul said patients were being discharged early because there was 'considerable pressure' on beds while the community care services championed by the Government had been 'dramatically reduced'.

'There is no doubt if a patient is readmitted it will require GP input again,' he said.

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