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Independents' Day

GPs to offer half-hour appointments as paramedics take on home visits

Exclusive GPs will be able to offer extended appointments that could last up to half an hour, after a group of local GP federations received £42m in funding from the GP Forward View.

According to GP leaders in Manchester, the funding injection has allowed general practice in the city to 'breathe' by paying for extended appointments and a wider clinical workforce in practices.

This includes hiring paramedics to take on nearly all home visits in the city, freeing up time for GPs to spend on patients with complex needs.

Dr Tracey Vell, chief executive of Manchester LMC, told Pulse that the extra funding ‘will make every GP have the capability to go to 20-30 minutes of quality, continuity-of-care appointments’.

Dr Vell added that with the extra time, GPs are able to spend longer with patients with complex needs, which she said is where continuity of care ‘really kicks in’. 

She said: ‘Continuity is less important for some populations, but what we are doing is giving patients that choice, we are not making it for them.

‘We are saying you can see your GP on this day, but if you don’t mind seeing any GP in a different setting on the same day, you could choose that.’

She added that the extended appointments scheme is 'assisted by the time we save in not doing home visits, or not every home visit'.

Dr Vell said that some of the £42m was allocated for 'additional workforce', adding that some practices have access to 'paramedics that are starting to do home visits for GPs', while a clinical pharmacist is now stationed in every GP ‘hub’.

GPs in Manchester operate in hubs of up to six practices, covering between 30,000 and 50,000 patients each.

The hubs are divided into ‘local care organisations’ (LCOs), with between five and six hubs in each of 10 LCOs across Manchester.

One LCO went out to tender earlier this year for a 10-year contract worth £6bn to deliver all non-acute healthcare except core GMS contractual services to 600,000 patients.

This comes as Dr Robert Varnam, NHS England’s head of general practice development, told delegates at the RCGP’s Annual Conference that GPs have 'chosen' to work in 10-minute appointment slots, which he said is 'unethical'.

Meanwhile, a review backed by the Chief Medical Officer found that a current average 9.2-minute GP appointment ‘does not give sufficient time' to discuss treatment options.

Healthcare devolution in the 'Northern Powerhouse'

Former Chancellor George Osborne announced two years ago that the NHS in Manchester  would become devolved from central Government, as part of the Government's 'Northern Powerhouse' plans.

The deal saw the local authorities, alongside CCGs, given the freedom to jointly commission health and care as they pleased in the local economy.

Since then, in an even more far-reaching shake up, NHS England has unveiled plans to devolve responsibility for commissioning to care organisations themselves.

This will see, in the long run, all of a current 44 Sustainability and Transformation Plan (STP) areas become 'accountable care systems' in future.

NHS England has named Greater Manchester as one of nine 'likely candidates' to become one of the first such ACSs.

In return for becoming an ACS, NHS England has promised the organisations ‘more control and freedom’ over their regional NHS including receiving devolved national GP Forward View, mental health and cancer funding from 2018.

Readers' comments (27)

  • That's odd because on the odd occasion I don't have any visits I still have plenty of work to do as it is.

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  • How many visits do they think we do in a day ?

    This would allow us to do two extended appointments. Like a drop in the Ocean.

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  • How about no home visits

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  • Vinci Ho

    Face value is attractive.
    Like everything, advantages and disadvantages.
    Will be interesting to see how the logistics will pan out . Some impact assessments are necessary.

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  • Despite some people's concerns, I think it is a step forward. Home visits are not a good use of time and I see this as the first step towards no home visits.

    In countries where people pay directly for healthcare, there suddenly seems to be far fewer people that 'need' home visits.

    Having said that we need to be aware of the risks. The big risk here is that people who are truly housebound are going to get a worse service. There is real irony in saying that paramedics are taking on home visits so GPs can have more time to work on the 'most complex' cases.

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  • Welcome to the end of general practice that we had ever known! We knew that this was coming anyway regardless of the skills that the paramedics may have. The days of the ‘family doctor’ that I was brought up in and tried to practice as a GP are well and truly gone whatever benefits that gave to patients. Welcome to the Grave New World

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  • What a fabulous idea! Thank goodness the housebound do not have complex clinical needs! Need more time with my ambulant fibromyalgic/ chronically fatigued cohort. As for cate of the dying, sure an ambo driver will be up to the job.

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  • Government introduces 37 hour days and 9 day weeks for workers who can't cope with a 9-7 day 148 days a year like them.

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  • How is the rest of the country going to cope after their paramedics have been snaffled to do this...Oh there's a sudden excess of paramedics now!?!!

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  • Cobblers

    Indemity. These paramedics are hired. Home visits are high risk. Are the doctors covering them or is it the GP Federation, whatever body that is?

    Oh and the £42million is non recurring, what then?

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