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GPs urged to ring vulnerable patients over weekend in attempt to cut A&E attendance

Exclusive An NHS England area team urged GP practices to call vulnerable patients on Friday night and over the weekend because the ambulance trust was unable to cope with unexpected winter demand, Pulse has learned.

In an email sent to practices via CCGs on Friday 12 December, NHS England’s (West Yorkshire) emergency preparedness, resilience and response (EPRR) lead Adam Bland also suggested that CCGs put out information to the public stating that their GP practice ‘might be open longer tonight or on Saturday’ because the Yorkshire Ambulance Service was experiencing ‘unprecedented demand’ and struggling to meet response rate targets for emergency calls.

But local GP leaders were angered by the email, and said the suggestion GPs should phone their patients over the weekend to ensure they wouldn’t bother the ambulance service ‘would be laughable were it not illustrating a total misunderstanding of the role… of general practice’.

It comes after Pulse reported last week that emergency admissions reached record levels last week, with nearly 5,000 more patients admitted than in the same period last December, despite new schemes like the unplanned admissions DES being brought in to tackle this.

The email said that Yorkshire Ambulance Service was ‘experiencing unprecedented demand’, which meant ‘they are struggling to reach all emergency calls in an expected time frame’.

It urged GPs to ‘make every effort: to ensure an ambulance transfer to the ED is the absolute last resort for all patients; to attempt to contact patients who might be at risk of requiring urgent and emergency care tonight and over the weekend to assess their health and help them access alternative services if necessary; to ensure any patient requests for appointments this afternoon and tomorrow are accommodated as much as possible.’

NHS England also said that the ‘public and patient message via twitter, websites etc’ should be: ‘The ambulance service are really busy today, a lot busier than usual. Your GP practice might be open longer tonight or on Saturday. Try them before ringing 111 or going to A&E. In a real emergency always call 999 but keep the ambulances for those who really need it.’

Dr Andrew Green, chair of the GPC prescribing subcommittee and a GP in Hedon, East Yorkshire, said he was ‘staggered’ by the email.

He said: ‘I was staggered that NHS England (West Yorkshire) would send this email to GPs at all, let alone at 4pm on a Friday afternoon, a time when most GPs will be fully booked with patients until the end of their contracted hours.
 
‘It is surely predictable that there will be times when ambulance services have increased demand, yet the head of emergency preparedness, resilience and response seems to think that the appropriate action for this is to try, with no notice, to ask a different part of the NHS to take on yet more unresourced work.
 
‘The suggestion that we might personally phone our sickest patients then or over the weekend to check they are alright and won’t bother the ambulance service would be laughable were it not illustrating a total misinderstanding within NHSE of the role, responsibillities, and workload of general practice.’

He added that the public message would give patients the idea that their practice should be open out of hours, ‘stoking patient expectations without there being any realistic possibility of them being met’.
Dr David Macklin, executive director of operations at the Yorkshire Ambulance Trust, said: ‘We are currently receiving hundreds of 999 calls every day to patients with breathing difficulties and other serious conditions.  We really need people to use our emergency service wisely so that we keep ambulances available for those patients who need life-saving help.

‘While many people do use our emergency service appropriately, some callers could be helped by other more appropriate healthcare services.

‘Anyone needing advice and treatment for non-emergencies should consider options such as contacting a local pharmacist or GP surgery, a call to NHS 111 or visit an urgent care centre.’

Pulse reported last month that GPs would be receiving just 3.5% (£25m) of a £700m tranche of additional funding to support the health service in coping with winter pressures.

NHS England (West Yorkshire) area team were approached for further comment but had not replied at time of publication.

Email to CCG leads from NHS England

 

From: Bland Adam (NHS ENGLAND)
Sent: 12 December 2014 15:55
To:
Cc:
Subject:
Message to GPs

 

CBU leads to cascade the following message to all CCGs to ensure that all GP practices have the following message by email and phone call:

Yorkshire Ambulance Service are experiencing unprecedented demand. This means that they are struggling to reach all emergency calls in an expected time frame.

Please can you make every effort:

·         To ensure an ambulance transfer to the ED is the absolute last resort for all patients

·         To attempt to contact patients who might be at risk of requiring urgent and emergency care tonight and over the weekend to assess their health and help them access alternative services if necessary

·         To ensure any patient requests for appointments this afternoon and tomorrow are accommodated as much as possible

Public and patient message via twitter, websites etc. The ambulance service are really busy today, a lot busier than usual. Your GP practice might be open longer tonight or on Saturday. Try them before ringing 111 or going to A&E. In a real emergency always call 999 but keep the ambulances for those who really need it.

 

Adam Bland

Head of Emergency Preparedness, Resilience and Response (EPRR)

NHS England (West Yorkshire)

Readers' comments (30)

  • Never fear, send Ivan Bennett in!

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  • Why not just publicise the GP out-of-hours service instead of (politicians and media bods) pretending that it doesn't exist?

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  • P**s off!

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  • If this "system failure-passing the buck-shirking contractual responsibilty" scenario was carried out by a GP surgery (or group), a ton of legal and other bricks would be falling on their collective heads. Mr Bland will of course get of scot free, thanks to his chums. Mind the ambulance!

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  • Oddly enough I suspect that NHS England may find that the goodwill has all dried up...

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  • Just rang MPS to defer/retire my membership and they were so busy they had to call me back......

    Could this be a mass exodus at the end of the year? Has anyone asked them how many GPs are deferring their membership and how this compares with previous years?

    I do have to say that in the 30 years that I have been a member of MPS they have been incredibly pleasant and supportive. I'm lucky that I have never had to use their help.

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  • Abdul QADRI

    Out of service has been working tirelessly for many years. Nhs England is trying to give impression that they are proposing this service. At the same time, it is not a bad idea to contact vulnerable patients over the weekend but one needs to keep in mind that gps have also got family life & they need resources to provide that service.

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  • Preumably the ambulance service are giving part of their budget to General Practice as well..........

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  • Dear Adam

    General Practices across the country are facing unprecedented demand for appointments. Often GPs are working 12-14 hour shifts trying to clear the backlog of paperwork, much of it imposed by secondary care.

    Please can you cascade to your secondary care colleagues so that they make every effort:

    - not to add "GP review" for every discharge out of the hospital
    - not to ask GPs to "review the patient and consider referral to the neurologist" - you're a bloody physician, you can do it yourself.
    -not to discharge patients ridiculously early that they;re back in ward AMU in 48 hours.
    -not to reject my gateway referrals because if Im referring, its because I actually want the patient to be seen

    Whilst you're at it, could you stop CQC breatehing down my neck because I've not got an enhanced disclosure in the last 6 months?

    Dr A Noyed
    GP
    Pretty fed up and Burnt out (PFUBO)

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  • Oh Doctor thank goodness you rang - I was going to wait till Monday but since you called could you see fit to admit me over the weekend .

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