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Gold, incentives and meh

Seven-day GP access pioneer hails cut in unnecessary A&E attendance

Exclusive The leader of a seven-day working pilot lauded by the Government has claimed the scheme has cut the number of unnecessary A&E attendances by more than a quarter in three months.

An early evaluation of the pilot scheme run by NHS Central Manchester CCG also found that the number of patients who said they attended A&E because they were unable to get a GP appointment had ‘halved’, the CCG clinical director Dr Ivan Benett told Pulse.

However, local leaders have said that extending access should not be a priority and warned these extra appointments do not receive the full clinical support available in hours.

Thie evaluation results follow the Government’s announcement last week of £50m worth of funding for 20 schemes across England to pilot extended hours access for one year.

The Central Manchester pilot, which was one of six in the north west of England was mistakenly hailed a success by the DH before it had actually begun.

The six schemes together received £2m worth of ‘winter money’ from NHS England’s local area team to reduce pressure on emergency services, and saw GP practices in four locations work in hubs to provide access from 8am to 8pm on weekdays, and between 8am and 6pm on Saturday and Sundays.

Dr Benett said the CCG now thinks that the project could become ‘self-funding’ because of the reduction it has achieved in hospital pressures.

He said: ‘We estimate this have led to a reduction of 27% in primary care attendance at Central Manchester University Hospitals  NHS Foundation Trust A&E compared to last year. There has also been a reduction of 50% of people turning up to A&E saying they are because they could not get an appointment with their GP.’

He added: ‘I’m confident that the extended hours will provide a better service and reduce urgent care activity so it will be self-funding.’

But Dr Tracey Vell, medical secretary of Manchester LMC and a GP in central Manchester, said there were concerns with the pilot locally.

She said it was a ‘duplication of current GP out-of-hours services’, adding: ‘We do not feel that routine appointments at these times are fully supported with pathology and other investigations.’

‘Politically, we feel that access for our patients is already great and that money could be spent on other projects.’

Last week, Pulse reported that the Government has not committed to continue to fund its nationwide scheme beyond next April, instead hoping they can prove self-sustainable and be carried forward commissioned by CCGs.

However, Dr Paul Charlson, who is the vice-chair of Conservative Health and a GP in Brough, East Yorkshire, said that a nationwide push for extended access remains at the heart of discussion within Tory circles ahead of next year’s election.

He said: ‘It is such a hot issue with the public that understandably the Government is keen to pick it up and encourage it. Whether that is by carrot or stick depends on a number of factors - one being GP recruitment.’

Dr Charlson added: ‘I personally would like to see a situation where there is a minimum number of face-to-face consultations per week based on list size, which I know has been talked about. This appears fair as there is significant variation in this across England which is not wholly explained by demographics.’

Asked about future plans for extending GP access, the DH said it would be ‘inappropriate to comment’ before next year’s GP contract negotiations had begun.

Pulse reported last week that experts have warned that stretching access over seven days threatened to hamper continuity of care and derail the health secretary’s bid to improve care of vulnerable elderly patients.

Related images

  • Dr Ivan Benett - online
  • Taken from issue
  • Dr Tracey Vell 330x330 online

Readers' comments (48)

  • The commissars continue in the colectivization of primary care.

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  • @8.52 LOL
    Or indeed his distant half cousin Peter Bonetti, late replacement for the great Gordon Banks left stricken by Montezuma's revenge at Mexico 70.
    2-0 and looking comfortable against the Germans.
    A stroll through midfield by the imperious Beckenbauer, a looping header by Uwe Seeler and finished off by der Bomber, Gerd Muller, after panic in the penalty area.
    2-3 and we are out!

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  • Three years ago when I was mad enough to join my local CCG Board I suggested that A and E departments should be paid for seeing minor injuries at the same rate as GPs were paid and that I did not understand why a review of a sprain was paid at a higher rate in a and e compared to GPs. I immediately got told off for daring to suggest such a thing 2 others GPs on my board then immediately disciplined me and I was told that I could not be trusted to work closely with the local DGH managers as they were "upset" by my remarks. This year our CCG board is making us code all minor injuries to see if we deserve any payment at all for seeing minor injuries. So instead of questioning the payments hospitals receive it's our payments that are in doubt which are tiny compared to the hospitals. This scheme like many others are successful because GPs are able to get things done cheaper and unfortunately many of our CCG colleagues are in cahoots with hospitals managers in order to save money by exploiting GPs goodwill and dumping more and more stuff on our doorstep. This project is yet another example of GPs being used by the system. It's time to say no. I feel really sorry for Manchester GPs. Una Coales we cannot wait for your motion and to be able to say to our CCG "leaders", the public and the government that we have had enough and wish to resign from the NHS.

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  • Ivan Bennett is a total Jeremy

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  • Una Coales

    @10:02 pm yes I am hearing that hospitals are charging CCGs for extra lists and paying consultants up to £200/h to see a list of up to 8 (fewer with DNAs) patients for follow ups. We GPs have also had to take the savings we have made and hand it back to hospitals who seem to always be in the red.

    Clearly we must negotiate for a contract that pays per service/consultation like the tariff hospitals and dentists charge.

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  • Support Una's motion...resign from the NHS

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  • 02 May 2014 7:41pm

    agree!

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  • Ban the drunks form A&E that would be a good start!

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