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GPs called in to treat patients in hospital wards

Exclusive: GPs are being called into hospitals and other secondary care facilities to register patients and treat them on wards in the most extreme move yet to dump work on practices.

The GPC has protested to the Department of Health over a series of incidents, arguing the practice is not only unfair but could put patient safety at risk. One LMC reported GPs had been asked to treat severely ill patients in inpatient settings, blurring the boundaries of clinical responsibility.

GP leaders warned hospitals were taking advantage of ambiguities in practice registration rules to argue GPs were obliged to treat patients even in inpatient settings.

Dr Richard Vautrey, deputy chair of the GPC, said the committee had discussed the issue with the DH: ‘It has affected practices around the country, and causes all sorts of problems. It has happened in private and NHS hospitals. It is a patient safety issue. We are encouraging practices to resist.’

The GPC’s annual report, published last month, said its contracts and regulation subcommittee had ‘received a number of reports of GP practices being asked to register and treat patients in secondary care institutions, with a blurring of boundaries between care provided by GPs and secondary care’.

Birmingham LMC said GPs in south Birmingham were called in to the private Hunters Moor rehabilitation centre, which treats severely disabled neuropsychiatric patients.

Dr Robert Morley, secretary of Birmingham LMC, said practices had been asked to treat patients who were the responsibility of consultants.

He said where secondary care institutions did need the services of a GP, they should procure them outside of GMS or PMS arrangements: ‘There are two questions here. Should GPs have to provide primary medical services to patients in hospital – that’s the grey area. But the area that isn’t grey is, should they be providing specialist services that are definitely the responsibility of the consultant?

‘GPs are put in a very difficult position. It’s part of the dumping of secondary care work onto GPs. Care is fragmented – there is no clear demarcation of where clinical responsibility is.’

Professor Mike Barnes, clinical director at Hunters Moor, denied GPs had been asked to do specialist work: ‘An expert team of consultants in neurology, rehabilitation medicine and neuropsychiatry is responsible for more complex medication. The medical team has liaised with the PCT and GP practices over GMS services, and together identified the most effective way of providing appropriate medical care to our mutual clients.’

Professor Barnes said GPs were asked only to provide ‘general medical input’, such as monitoring and treating blood pressure, managing patients with diabetes and prescribing painkillers: ‘Patient safety has never been compromised.’