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Hakin: Poor GP care responsible for rising emergency admissions

The deputy chief executive of NHS England has blamed ‘poor general practice’ – especially in inner cities - for the increase in emergency admissions.

Dame Barbara Hakin told MPs on the Public Accounts Committee today that poor access to general practice would lead to a higher number of A&E attendances, but not necessarily admissions.

However, she also said that ‘poor general practice’ leads to ‘unnecessary and avoidable admissions’.

Answering a question from Meg Hillier, the Labour MP for Hackney South and Shoreditch, on the removal of the guarantee of an appointment within 48 hours, Dame Barbara said there was ‘no evidence’ it had led to increased emergency admissions.

She said: ‘I don’t think there is any evidence it has led to an increase in emergency admissions – if the general practice is poor, it will be other aspects of it rather than immediate access. Poor access will lead to more attendances at A&E.

However, she added that ‘poor general practice’ will lead to emergency admissions. ‘They don’t look after patients as well in the longer term, which can lead to unnecessary and avoidable admissions. We do know we need to make a big improvement in some places.

‘Lots of general practice is very good with good access. But in some places, the standard of general practice is too poor, the access of general practice is not immediate enough. It is quite often that that is in inner cities, in urban areas and of course that is where our hospitals are sited, so those patients unsurprisingly go to A&E.’

Readers' comments (16)

  • Whilst we must accept criticism is her opinion evidenced?

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  • Vinci Ho

    Do people read the news?
    The number of people receiving social care support , particularly those over 65 has fallen by 25% in last 4 years. So this is the fault of GP as well????

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  • Vinci Ho

    Am I right to say if these patients did not get the social care they need , they can end up attending A/E and even being admitted?
    Look into your conscience before you try to defend the government you serve.

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  • Yeah - this is Mr Hunt's thinking -lets blame the poor GP - not many GPs left to work in high demand, high deprivation, poor social care, communications issues -immigrant concentrations, alcohol-drug problems,mental health problems, high crime rates etc- also these GP practices are low income due to low QOF achievements, low smears rates, low vaccination rates etc due to poor attendances and compliance issues(it is hard work). Does Dame Hakin live in a inner city area or use the NHS for her health needs??

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  • Not sure what she means by 'poor general practice'. Is there a validated measure of this, or is it a soundbite that can be massaged to mean whatever she subsequently chooses it to mean? If practices are not performing, there are an army of regulators whose responsibility is to raise the level. So....what is the point of her saying things that mean nothing.

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  • I think by inference she means that: 48hr target was good general practice and by removing it then bad general practice has been introduced - otherwise why mention it in a question specifically about the 48hr target? In effect she was saying it will lead to bad practice but it will not show in emergency admission it WILL show up in increased A&E attendance. A direct criticism of Jeremy Hunts current process of phoning trusts about A&E targets when obviously in her own opinion he should have known this would happen in the 48hr target was removed! In effect she is turning on the government and telling them what the obvious consequences of their policies were! Good on her at last someone at NHSE directly challenging the government and Jeremy Hunt! She is quite right to point out that he is trying to blame others for his governments bad policy decisions (in effect implementing bad general practice)! The question is whether this a hint as to government policy direction - in that their only way to control A&E will be to reintroduce a target, and workload on Practices, they themselves scrapped (ie yet another failed policy and subsequent U-turn)?

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  • "I don’t think there is any evidence it has led to an increase in emergency admissions"

    Dear Babs, how about you KNOW whether there is any evidence or not.

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  • Since there hasn't been an increase in A+E attendance (as distinct from WICs and Nurse led centres) [Kings Fund Report] why should we take these comments seriously at all?

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  • Stop beating about the bush."poor general practice – especially in inner cities" is code for immigrant communities abusing NHS services and the mainly asian doctors (usually 1st generation docs from the Indian subcontinent) who serve these deprived areas not being good enough.

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  • Ivan Benett

    It is quite clearly nonsense to blame poor GP practice 'especially in inner cities'. It is a whole system problem for which each part of the health system carries some responsibility. For our part, as GPs, we could be more accessible for some of the 'minors' that turn up in A&E and account for most of the 4hr breaches, and we could be more proactive in managing people with longterm conditions - especially frail or with multiple morbidities. The rest of the system also needs to improve what it delivers, including the public itself, who could go to other places for advice like pharmacies, or just put up with the discomfort of coughs and colds....as I am right now! Cough, splutter

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