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GPs to oversee all vulnerable patients under emergency admissions DES  



GPs will be responsible for case-managing and preventing hospital admissions – through direct phone contact with emergency providers and patients – through a new DES.

The new DES will be funded through the abolition of the quality and productivity domain of QOF and will mean GPs have to improve services for patients with complex health and care needs, who may be at high risk of unplanned admission to hospital’.

This will mean all vulnerable patients will be ‘proactively case managed’ and have a named, accountable GP co-ordinating their care.

The service will require GPs to provide ‘timely telephone access’ to relevant providers to support decisions relating to hospital transfers or admissions, in order to reduce avoidable hospital admissions or A&E attendances.

They will also have to improve access to telephone or, where required, consultation appointments for patients identified in this service.

The DES will also require that GPs review and improve the discharge process, sharing relevant information and whole system commissioning action points to help inform commissioning decisions and undertake internal reviews of unplanned admissions/readmissions.

Funding for the service comes from the retired QP domain of QOF worth 100 points, as well as additional £42 million from discontinuing the DES introduced this year on risk profiling.

GPC deputy chair Dr Richard Vautrey said: ‘Practices need to ensure that if somebody from A&E is treating one of their patients and wants get through to the practice to find out what drugs they are or what happened in a consultation earlier on, there is a swift way of that clinician being able to contact practice.

‘That might mean providing a specific number for A&E or a more dedicated ex-directory line, potentially ensuring there is prompt access for such situations.

‘This applies to the contract so has nothing to do with out-of-hours. This is about the responsibilities for the practice in terms of their contract between 8am and 6:30pm.’

NHS England said GPs would need to offer patients same-day telephone consultations and provide other healthcare professionals with a direct line, but there would be no need to deliver 24-hour access.

A spokesperson told Pulse: ‘There is no 24-hour helpline requirement in the contract. The new enhanced service on reducing emergency admissions includes a requirement that the practice offers a dedicated telephone line.  

‘Practices will provide high-risk patients who have urgent queries with same-day telephone consultations or with follow-up arrangements where required.

‘The second dimension is improving availability for other healthcare providers such as A&E clinicians, ambulance staff and care and nursing home staff, who will be able to use a dedicated ex-directory or bypass number to gain convenient access to the practice to support decisions relating to hospital admissions and transfer to hospital when vulnerable patients present.  This will apply during contracted core hours.’