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NHS England sets out 'aspiration' for GPs to guarantee patients an appointment within four hours

GPs may have to provide access to patients within just four hours under ‘aspirational’ plans set out by an NHS England regional area team.

The proposal, made by NHS England’s London regional director Dr Anne Rainsberry at an event to ‘improve primary care’, was welcomed by the Department of Health, which praised it as an ‘innovative’ scheme to keep people out of hospitals.

However, local GP leaders said that NHS England in London was wrong to blame ‘poor primary care’, and that it should instead look for ‘sensible solutions’.

Dr Rainsberry told journalists at an event yesterday that offering patients four-hour access to GPs would help ease pressures on A&E.

An NHS England in London spokesperson told Pulse afterwards that Dr Rainsberry’s comments should be seen as an ‘aspiration’.

The spokesperson added: ‘It was part of a discussion about young people in London visiting A&E departments rather than GP services as they know that they will be seen within four hours. Our position is clear that primary care needs to change to meet the needs of the whole London population.’

A DH spokesperson said: ‘It is encouraging to hear about the innovative plans GPs are putting in place to deal with the high demand on A&E services.’

‘GPs are ideally placed to support people to stay well and out of hospital and we are working closely with NHS England to consider how primary care can be further strengthened to support such innovative ways of working. This will form a key part of our vulnerable older people’s plan, due to be launched in the autumn.’

Dr Rainsberry’s remarks came at the launch of an NHS England London regional team initiative to ‘improve primary care’, attended by more than 200 NHS and social care leaders who met to discuss ‘recovery and improvement plans showing how GPs, social care providers and community services can provide better out-of-hospital care for people with long term conditions or non-life threatening but urgent care needs’.

But Dr Michelle Drage, chief executive of Londonwide LMCs, said: ‘NHS England London say the problems of A&E in London are due to poor primary care. We say the problems of general practice in London are due to a complete lack of investment over the past two decades in our primary care infrastructure in London, combined with ridiculous four hour targets which encourage attendance at A&E.

‘London’s GPs expect NHS England London to talk to Londonwide LMCs about how to agree sensible, sustainable and realistic solutions to address the root causes of their concerns, if together we are to crack these issues.’

Readers' comments (34)

  • I assume we'll be provided with the same level of funding AED has then? £75/patient visit was it?

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  • Surely this idea should only be suggested if there is clear evidence that it saves lives, otherwise I would rather spend the money on medications that have been proven to work.

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  • @above
    What are you going on about???Do you know the NNTs for the medications "that have been proven to work"?Order judicial review of all these big pharma influenced guidleines and i'll guarantee you will save NHS billions.

    As for the topic in hand doesn't NHS England realise that if we are to see patients within 4 hours of request we'll essentially be an A/E service(without the resources) with no time for chronic disease management?

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  • When we set up a similar scheme locally, the very enthusiastic GP lead eventually came to our ED to show us how it was done.

    After a long day, he finally achieved his goal... He managed to turn one patient away to be seen in their local practice. How we laughed!

    This is undeliverable and will not work

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  • What's next? NHS England to suggest GPs will have to cut crime rate by 15%? Or perhaps find immortality by 2016? Or perhaps all GPs to act as immigration officer and check immigration status of the patients before they register?

    Oh wait........

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  • So patients who do not want to take time off from work, swimming lessons or the boiler man coming to their house, pitch up to A/E and are clogging up the system. So instead of addressing their unreasonable expectations, GPs are being told to match the ridiculous targets of A/E.

    What a bunch of muppets we are....

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  • The problem is capacity .... How many patients
    Is it reasonable for an individual to see in a day
    and give appropriate time for consideration of their
    problems.
    How many hours is it reasonable to work safely?
    What about day time call outs? I work in rural practice
    with long travel times.
    What about the rest..such as
    We now manage chronic disease and its f/u's
    we are also asked to manage and take over commisioning .
    What about Gold standard meetings
    Signing scripts
    dictating letters
    Going through results
    audit
    CQC
    Nice aspiration but making such statements without adfing substance is unhelpful
    Remember practices were stripped of money and hence responsibility
    to see minor injuries so redirect them to MIU's
    To have this system in the current financial
    Envelope will mean longer (much longer)
    Waits for routine apts so will disadvantage
    another set of patients.
    If A and E is where patients go put the resources
    there ?
    Have GP's working there?
    Why try to tell patients what they are doing
    Is wrong just meet the demand by allocating
    Some community resources in A and E
    The money saved on admissions surely
    would pay for its self?

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  • Very Good idea if Govt. can pay GPs £ 50/- per consultation for 4 hour URGENT consultation as advised by (out of touch) Directors, everybody will love it.

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  • "The spokesperson added: ‘It was part of a discussion about young people in London visiting A&E departments rather than GP services as they know that they will be seen within four hours. Our position is clear that primary care needs to change to meet the needs of the whole London population."

    so because services are inappropriately used in London every GP surgery in England has to see anything within 4 hrs........ to relieve pressure on A&E. So essentially we need to offer an A&E service, on top of GP service, whilst referring less, diagnosing more, prescribing less, making sure that secondary care are treating appropriately, doing border agency checks, for a pay cut, 24 hrs a day until we are 68, oh and chronic disease management, QOF and CQC.

    If only we had any idea what pressure actually was

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  • In 2005 she was awarded a Doctorate of Business Administration with distinction.

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