Posted by: Pulse Team Blog5 July 2013
Anyone would think there was an election looming with all the frantic activity from the Department of Health.
We have had a rapid-fire of policy announcements of late – migrant access to the NHS, chief inspectors of this and that, and something about GPs and out-of-hours care (you may have missed it) - with varying degrees of detail, but they all follow a similar pattern.
A Daily Mail friendly series of leaks on a new idea to national journalists, leading up to a ‘keynote’ speech from the health secretary where he ‘reveals’ more details on his plans.
Except – like a cheap fun-fair illusion – the policy details are often more complicated than they first appear.
Take the idea of a ‘named clinician’ for elderly patients, announced today. A vote winner, I am sure, harking back to the days of single doctor patient lists and single-handers in converted terraced houses.
But those days are almost gone and looking at the details of the plans published by the DH, I struggle to see the difference between what general practice provides now, and what Mr Hunt wants to achieve.
The consultation calls for the most vulnerable elderly to have ‘someone in primary care’ taking responsibility for ensuring that their care is ‘coordinated and proactively managed’. It goes on to say that when a vulnerable older patient needs follow-up or ongoing support having left hospital that ‘somebody is accountable for their care’. Is this not what GPs currently do?
Admittedly, the proposal that there should be someone with whom the ‘buck stops’ and an ‘identifiable point of contact for a patient or their family’ may suggest a return to all-hours GP responsibility for patients, but how it will be structured remains unclear. The document says that those responsible may not have to provide the care directly themselves, but how this is a change from the responsibility GPs currently have to follow-up and organise care for patients after being in hospital is not explained.
The GPC – and most GPs - react with bemusement (another common feature of these announcements). ‘Every patient already has a named GP,’ says Dr Laurence Buckman. ‘GPs are responsible – I don’t know what he thinks this means.’
On top of this, DH policy seems to be pulling in different directions. Other areas of the consultation raise the prospect of greater use of ‘rapid walk-in access’ and looking at ways to ‘extend GP choice’. How is this going to ensure that patients have better continuity of care?
The whole thing may become clearer once final proposals are published later on in the year, but currently it smacks of something that is being prepared in broad brush strokes for the Conservative Party manifesto in two years time. Not a great surprise from a consummate politician like Mr Hunt, but smoke and mirrors can only distract from the real problems the NHS is having at the moment for so long.
Nigel Praities is deputy editor of Pulse