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GPs go forth

Row as GPs landed with post-op checks

GPs are to have up to three-

quarters of a million post-

operative checks dumped on them every year for conditions such as varicose veins, hernias and joint replacements.

The Department of Health has said no nationally agreed funds will be attached to the work and GPs will have to thrash out local deals with PCTs.

But the failure to commit to paying practices has sparked

an angry reaction, with the

GPC warning 'it simply won't happen if there is no funding'.

The plans were unveiled this week by Dr David Colin-Thome, the Government's primary care tsar. He insisted post-op checks in hospital would be scrapped for a range of clinical areas including orthopaedics, with patients instead encouraged to 'pop in' to see their GP if they had any concerns. He argued six-week post-surgery checks for everyone did not make economic sense.

Health Secretary Patricia Hewitt said the department was investigating the possibility of 'releasing resources from acute hospital care for general practice work in the community'. But a department spokesperson said these decisions would be determined at PCT level.

GPC negotiator Dr Richard Vautrey warned of a postcode lottery: 'Experience shows PCTs work very differently with GPs.'

The department has refused to confirm whether GPs will be expected to offer formal appointments to patients no longer checked in hospital.

Dr Laurence Buckman, deputy GPC chair, said: 'We think it is a perfectly good idea to bring more care closer to the community. But it simply won't happen if there is no funding.'

He stopped short of calling for a boycott of the checks but warned 'you can't force GPs to do it', while suggesting it was 'remarkably unlikely' the Government would succeed in stripping funding from hospitals to pay GPs.

Dr Colin-Thome's report, Keeping it Personal, argues 'there are potentially huge savings for the NHS', in cutting hospital appointments by moving less complex work to primary care. It also says GPs could be provided with direct access to diagnostic tests such as MRI scans for backs and knees.

GPs warned they would need extra training as well as fresh resources if they were to take on the new work. Dr Idango Adoki, a GP in Eastbourne with an ageing practice list, said: 'Some orthopaedic surgeries are fairly major and GPs would struggle to deal with check-ups. Training would be needed and hospitals would have to work much more closely with GPs.'

Dr Paul Searle, a GP in Huntingdon, Cambridgeshire, complained it was a case of GPs having hospital work 'heaped' on them on top of their already

demanding schedule. 'There isn't time to do general practice itself as it is. But no amount of fighting back on our part seems to make any difference.'

• Comment, page 80

What the changes mean for GPs

• End to routine six-week

post-operative hospital checks

for every patient

• Responsibility to pass to GPs

for post-operative follow-up

for operations including orthopaedics, hernias and varicose veins

• Changes expected to affect up to three-quarters of a million patients every year

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