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Government’s flagship named GP scheme ‘is not effective’

The named GP scheme has not successfully improved continuity of care or reduced emergency admissions, a study has found.

The scheme, which was introduced in April 2014 and was former health secretary Jeremy Hunt’s flagship policy, assigned a specific GP for patients aged over 75 to be responsible for their care.

It hoped to provide more personalised, proactive care for patients and in particular improve continuity of care. 

Mr Hunt said the policy would mean patients would have someone to ‘champion’ their care and would correct the ‘mistake’ made in the 2004 GP contract which ‘undermined’ trust between a doctor and a patient. 

However, the study published in the BMJ Open, found that continuity of care did not improve, and hospital admissions did not decrease. It called for more ‘sophisticated’ interventions to be made instead. 

The study looked at 19,000 patient records in 139 GP practices in England and linked it with hospital data to compare their healthcare use in the two years before and after the scheme was introduced. It looked at results for those aged 75-84 and 65-74. 

It found that continuity of care decreased at a similar rate in both age groups after the scheme was introduced. Hospital admissions also increased in both age groups, with a greater increase in over-75s. 

Dr Peter Tammes, senior research associate at the University of Bristol and lead author, said: ‘The named GP scheme appears not to have delivered hoped-for results in terms of improved continuity of care and reduced emergency hospital admissions for older patients.

‘This suggests that the policy of allocating a named GP is not, in itself, effective and more sophisticated interventions are needed.’

A previous study in 2016 also found that the policy did not have an impact on continuity of care but the Department of Health at the time said it was too soon to write off the policy.

However, this new study called for alternative ways to improve care for older patients.

The study said: ‘Allocating a GP does not imply that patients are able to see or speak to that GP whenever they require advice or care since this depends on GP workload, practice opening hours, salaried and part-time working contracts.

‘A policy of allocating a named GP in itself is not effective and more sophisticated interventions would be needed to improve continuity of care in the UK or countries with similar healthcare systems.’

Dr Tammes also questioned how the scheme was implemented and whether it could have been improved had patients been given the option to decide who their named GP was.

He added: ‘We did not interview patients and staff about what they thought about the scheme, so our understanding of why it does not appear to have worked is therefore limited. We would urge policy makers to look at other ways of improving care for this older patient group, taking both patient and GP views into account.’

Dr Richard Vautrey, BMA GP Committee chair, said: ‘We have seen a significant increase in demand on GP services since the named doctor scheme was introduced in 2014 and so it is no surprise that these results show a negative impact on continuity of care.

‘With an ageing population continuing to place more and more pressure on general practice, the Government must work with doctors and practice staff to find other ways to improve care for these older patients and in turn help reduce some of the burden on GPs.’

It follows plans to overhaul NHS Health Checks in a bid to end ‘one-size-fits-all’ check-ups. A review will look at creating a more tailored check-up in order to better prevent and predict diseases.