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Urgent care centres to send thousands of cases back to GPs

Government plans to replace A&E departments with new urgent care centres run by GPs and nurses could swamp practices with unresolved cases, new figures suggest.

One of the first urgent care centres in the country to open is sending as many as 40% of its patients back to their GP, it emerged this week.

The new centres are being developed as a gateway to emergency and urgent care – in a bid to free up A&E departments. But GP leaders attacked the plans as lacking an evidence base and repeating the errors made with walk-in centres.

It follows a recent warning from the College of Emergency Medicine that it had ‘serious concerns' about the centres, which it said were being imposed for reasons of cost and without evidence of ‘clinical or financial benefits'.

The urgent care centre in Hemel Hempstead - which saw 6,309 patients in its first three months of opening – predicts it will eventually treat 65% of patients currently visiting A&E.

But discharge figures show that 38% of patients were told to contact their own GP; with just 27% discharged. A further 16% of patients were referred to hospital, with 7% referred to A&E.

Herts Urgent Care – which runs the centre, has hailed the venture as a success. It is the first of eight centres planned for Hertfordshire as part of the Government's nationwide rollout - being driven by SHAs in the wake of Lord Darzi's Next Stage Review.

But Dr Peter Graves, chief executive Beds & Herts LMC, said the policy had been ‘forced upon us without appropriate consultation'.

‘We wish they had used walk-in-centres as a model for whether these would work or not. We had some disastrous stories - they led to serious financial deficits for PCTs, and sent people back to GPs for stuff they said they would deal with.

‘We need to see whether this is cost-effective resourcing, with patients benefiting, not, simply liking it. We believe there are better ways of using the resources, and we still have concern about how this will interfere with continuity of care.'

A spokeswoman for Hertfordshire PCTs said: 'The 38% of patients who are referred back to the GP following their attendance at the Urgent Care Centre will have been assessed and treated by clinical staff at the Urgent Care Centre.

'The handing over to the care of a GP is for a follow- up after the urgent treatment that the patient will have received at the Urgent Care Centre. This follow-up is likely to be for things like changing dressings and taking out stitches by practice nurses and for possible medication from GPs.

'This is not new work for GPs and these patients would have been referred to their GP for follow up had they been treated originally at a traditional A&E department.'

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