Reid tells GPs to learn from US-style care
Health Secretary John Reid has told GPs the NHS must learn five key lessons from controversial US health care provider Kaiser Permanente.
Mr Reid's aggressive defence of the Department of Health's eight pilots linking primary care trusts to Kaiser appeared to signal a drive to increase the number of GPs with special interests.
He called for an end to the 'sterile debate' on how funding should be divided up between primary and secondary care and demanded a more integrated approach.
He told a conference organised by Natpact, the Government body that supports PCTs, he felt the NHS could adopt five key principles pioneered by Kaiser (see below).
PCTs could kickstart the process by 'employing medical specialists in areas like diabetes and asthma care to move away from a hospital-focused system', he said. De-coupling medical specialists from hospitals meant there was 'no incentive to build up facilities in
the hospital at the expense of other settings'.
The department said an increase in the number of GPs with special interests was planned together with more hospital specialists working in primary care settings.
Mr Reid endorsed the Kaiser philosophy that every acute admission is 'an indicator of system failure' but the department insisted: 'GPs are not being blamed for hospital stays.'
Andrew Donald, Natpact director of operations who went on a department visit to California in February to study Kaiser's methods said it was inevitable there would need to be an increase in the number of GPs with special interests. 'What we are trying to achieve is to get more clinicians working in extended roles,' he said.
Somerset LMC secretary Dr Harry Yoxall, who practises in Taunton where one of the Kaiser pilots is taking place, said: 'It's important to make the best use of the skills of practitioners and back-fill, but the question is whether we have enough people to do the back-fill.
'If a GP is spending all his time doing other things that's not necessarily going to be welcome to patients.'
Reid: five lessons NHS can adopt from US
· Integration of inpatient and outpatient care and of prevention, diagnosis, treatment and care with more specialist GPs and hospital doctors working in the community
· Keeping patients out of hospital through better preventive care and greater use of intermediate care
· Active management of patients better identification of at-risk patients and more intensive management of chronic diseases
· Self-care and shared-care better patient education and support
· Use of IT easier access to patient records and more use of chronic disease registers