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GPC to propose radical plan to merge all unscheduled NHS care in bid to solve out-of-hours crisis

Exclusive The GPC is poised to publish an alternative plan to improve out-of-hours care, proposing all unscheduled care is merged together and rebutting the health secretary’s call for contractual changes to force the profession to take back 24/7 responsibility for their patients.

In an exclusive interview with Pulse, the new GPC chair Dr Chaand Nagpaul said they would propose that out-of-hours care, walk-in centres, minor injury clinics are merged and work together with the NHS 111 service.

Dr Nagpaul said that Jeremy Hunt’s call for contractual changes was a ‘red herring’ and ‘missed the point’ of how to solve the real problems with out-of-hours care.

He also said that CCGs had not been given real power over the budgets for unscheduled care and that many GP commissioners were ‘hamstrung’ from sorting out their out-of-hours care issues locally.

The comments are the first sign of how the GPC is going to fight back against a concerted campaign from the health secretary to force GPs to take back 24/7 responsibility for their patients.

Mr Hunt has suggested said he wants GPs to ‘sign off’ care for their patients out of hours and that he wants ‘the buck to stop’ with GPs by making them the accountable clinician for all the care their patients receive outside hospital.

But Dr Nagpaul branded the idea was a ‘populist tick-box’ and said that the GPC would be pressing for a different vision for out-of-hours care with all services providing unscheduled care locally working together.

He said: ‘The GPC has recently produced a document we will be publishing, proposing our version, our vision of how out of hours services can work in the NHS. We believe this does offer a sensible way forward that would meet the needs for patients.

‘I think the important thing for out-of-hours is to give GPs the ability to influence the organisation and delivery of out-of-hours services. We think the idea of talking about GPs being personally responsible contractually is a red herring and isn’t actually addressing the problem.’

He added that additional resources and a different model for out-of-hours care was needed: ‘We do not see the sense of having all of these separate players providing unscheduled care out of hours. To have 111 operating as a separate entity, having Darzi clinics seeing patients separately, having A&E minor injury clinics, and GP out of hours all separately.

‘We see an enormous benefit in bringing all the multiple unscheduled care providers together, but also bringing social care into the picture, to create a coordinated whole. We believe this will be able to offer patients the care they need out of hours.’

The announcement is the first big policy statement by Dr Nagpaul after being elected chair yesterday.

Hitting out at the Government, Dr Nagpaul said CCGs have not been given real power over the unscheduled care budgets and that the idea of having a ‘named clinician’ was not something that the GPC supported.

He said: ‘What we don’t want is a system which is either just a token gesture, neither do we want a system that is not deliverable. I think we need to learn more about what the Government wants with this and move away from a populist tick-box that you’ll have a named clinician.

‘We shouldn’t be talking about a named clinician, it is putting an end product before thinking what the needs are. So what I want it a dialogue with the Government about patient needs, patients of all categories.’