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Gold, incentives and meh

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Of course GPs in A&E won't improve access


Actually, the idea is to reduce admissions. It won't do that either. By the time the sick-enough-to-admit turn up it's too late. If they turn up with a Primary Care problem it will get charged as an A&E attendance anyway. Extended hours has reduced Primary Care type attendances at A&E, but at a cost. I have argued that the cost is reasonable for opening a service 8-8 during the week and 3 hours Saturday & Sunday. I know others don't agree. But the main problem is the high acuity attendees at A&E who need admitting. When they attend it's too late to turn them away. Many of them have COPD, heart failure, diabetes, or are elderly frail people with dementia, or any combination of the above. For each of these there are evidence based interventions that prevent acute deterioration. They need interventions early in that deterioration e.g. Rescue packs for COPD, diuretics for heart failure, antibiotics s for UTI in dementia. All of these are Primary Care interventions. So we need GPs to be proactive and anticipatory with these interventions early. For that you need good same day access to the practice. Not an appointment in 3 weeks once you've got past the receptionists.

Posted date

14 Mar 2017

Posted time