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GP access being reviewed under ’round the clock’ elderly care plan

Improving access to GP surgeries will form a major plank of a strategy that aims to better manage the health of vulnerable elderly patients and prevent emergency admissions, the health secretary announced today.

Jeremy Hunt told MPs in the House of Commons that they will look at whether primary care has the ‘investment and skills’ to deliver greater access, and would seek to ‘restore confidence’ in out-of-hours care.

The Department of Health said that access to primary care will be one of three major areas to be tackled in a plan to be published later this year that will tackle how GPs ‘can best meet the needs of older people and those with long term conditions’.

Mr Hunt told MPs: ‘This year we will be looking at primary care and patients’ access to GPs.

‘We will look at incentives, and whether primary care has the investment and skills to deliver this. We will look at how to restore confidence in out-of-hours care in light of the disastrous 2004 GP contract. And we will look at barriers and incentives that will stop people from getting joined up care.’

The announcement comes after the DH confirmed a major NHS review would consider practice opening hours and the possibility of GPs taking back out-of-hours care, after the health secretary said that ‘inaccessible primary care’ was to blame for the rising pressure on A&E departments.

The DH said this review, a review of access to primary care and ongoing work on promoting integrated care in the NHS, would feed into the plan to ‘meet the demands of people with more complicated health needs’.

A DH statement ahead of the announcement said: ‘We need to look at what is happening before and after someone reaches crisis point.

‘General practice plays a crucial role in proactively managing the health of vulnerable older people, many of whom have long term conditions. Some areas do this well, preventing emergency admissions but this should be happening everywhere.

‘NHS England is working with CCGs to look at how general practice can best meet the needs of older people and those with long term conditions.’

In an interview with the The Independent newspaper published today in advance of the announcement, Mr Hunt said the plan would put ‘round-the-clock’ care in place for vulnerable elderly patients, and that that GPs would form ‘a major part of the solution to out-of-hours care.

Mr Hunt told the Independent that every vulnerable elderly patient would be given an individual case worker, although he refused to confirm who this would be.

But he added: ‘GPs will definitely be part of the [out-of-hours] system and I think GPs could be a major part of the solution. But this exercise that we are going to do between now and October will identify how we can give vulnerable older people the round-the-clock care they need.’

Further, despute imposing an increased range of QOF targets on GPs in the 2013/14 contract, Mr Hunt also used the interview to slam a ‘tick-box’ approach to general practice care.

He said: ‘If you make a GP’s financial reward the number of aspirins they give to patients, you de-professionalise them because you’re saying you’re not going to trust their clinical judgement. You also make it impossible for the GP to treat the person rather than the condition.’

‘There should be no hiding place for any professionals who don’t meet the highest of standards - but I do think you have to have faith in the people of the NHS as being people who want to do the right thing. And if we create the right structures, they will do that.’

DH spokesperson said: ‘In drawing up a Vulnerable Older People’s Plan, we will look at levers in the system that prevent joint commissioning and stop people from getting joined-up care.

‘It’s too early to say what these might be, but we will look at any incentives that can act as an unnecessary and counter-productive barrier to giving holistic care.’

RCGP chair Professor Clare Gerada welcomed the new strategy to develop a truly ‘whole system’ approach to care for vulnerable elderly patients, but warned it needed to be adequately resourced.

‘To achieve meaningful change the review must look at the huge workload challenges facing GPs and ensure that the right investment is in place to enable primary care to deliver for elderly patients.’