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GPs go forth

Trusts ignore GPs' desire to take on a special interest

Two reports from the Audit Commission reveal there are major problems in GPs' relationships with PCTs – Nerys Hairon reports

Primary care trusts are failing to use GPs to help redesign NHS services and cut hospital waiting times, a report by the public spending watchdog finds.

The Audit Commission concluded many PCTs were overlooking GPs' desire to take on a special interest because they were 'too pessi-mistic' and had not asked GPs about the move.

Only three of the 10 trusts visited felt doctors were interested in developing a specialty, yet between 21 and 47 per cent of GPs said they were willing to do so.

But the commission also found many GPs were disillusioned with the special interests programme. GPs said trusts only wanted them to take on specialties to 'solve secondary care problems' and help meet waiting time targets.

The commission said it was 'concerned' after finding the majority of trusts were failing to monitor whether using GPs with a special interest was cost-effective.

Overall, the report, 'Quicker Treatment', found patchy uptake of the scheme with fewer than one in five trusts having GPs in more than five specialties.

Dr David Jenner, GMS contract lead at the NHS Alliance, said GP shortages were a major problem in developing the special interest scheme.

He added: 'Numbers of consultants have doubled in the last 10 years whereas GPs have gone up by 8 per cent. It's hard enough doing the day job, but there are some GPs for whom doing a special interest rejuvenates them.'

GPs at four PCTs said arranging cover if they were to take on specialist sessions was a major problem and nine out of 10 trusts said they had difficulty finding locums.

GPC joint-deputy chair Dr Hamish Meldrum said GPs should be encouraged to maintain their generalist role.

'I would not want a situation where every GP has to

be a specialist as it is too far away from their prime role,' he said.

Andy McKeon, head of health at the Audit Commission, said it was vital GPs were involved in deciding how trusts redesigned services.

GPs with a special interest

Key findings

l82 per cent of trusts have redesigned some services using GPs with a special interest

l17 per of PCTs have GPs covering five or more specialties

l36 per cent of new services are only provided by one practitioner, making them vulnerable to staff leaving

lSome GPwSI services take fewer than 10 per cent of GP referrals

lMonitoring in most PCTs is 'weak'

lOnly 7 per cent of trusts felt they had sufficient management staff

lThree out of four trusts felt they did not have enough clinical staff

lOnly 27 per cent of GPs felt they had influence over hospital commissioning

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