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5. Sir Bruce Keogh

Medical director, NHS England

It is Sir Bruce’s findings around failing hospitals that have made headlines, but his urgent and emergency care report could fundamentally change out-of-hours services and access in-hours.

His investigation of 14 hospitals with mortality rates which have been consistently high for two years or more followed the Mid-Staffordshire report published earlier this year and resulted in hit squads being sent into 11 hospitals.

The urgent and emergency care review has already thrown up a slew of proposals which are currently out for consultation. Many of these relate to greater access to GPs out-of-hours including more out-of-hours telephone consultations and giving GPs same-day access to specialist opinions.

But the most controversial proposal is for practices to provide 24/7 ‘decision support’. How that can be achieved without GPs being on call 24/7 will become apparent after Sir Bruce’s final report in the autumn.

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