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Hunt sets out plans to ‘rethink’ primary care as BMA demands urgent talks over out-of-hours attack



The health secretary has announced a new initiative to ‘rethink the role of primary care’ and remodel it to prevent emergency admissions and A&E attendances in patients with long term conditions, with a number of local ‘pioneer sites’ due to be announced shortly.

It comes as the BMA called for urgent talks with Jeremy Hunt over claims that the 2004 GP contract was ‘disastrous’ for the NHS and was to blame for high attendance at A&E departments.

In a speech this afternoon, Jeremy Hunt has said that primary care must return to its ‘root purpose’ of looking after patients in the community and ensuring they don’t become ill, rather than ‘simply acting as a gateway’ to hospitals. Click here to read the full speech.

He said that plans would soon be announced for ‘local pioneer sites’ to lead the way on developing this model of care, with GPs actively supporting patients to manage their health.

Mr Hunt used today’s speech to reiterate that ‘inaccessible primary care’ was to blame for the rising pressure on A&E departments, which he admitted was the ‘biggest operational challenge facing the NHS right now’.

He added that often patients were not being managed adequately by GPs, and this was contributing to rising levels of emergency admissions.

Speaking at an Age UK conference in London this afternoon, he said: ‘The challenge is to rethink the role of primary care, in particular its ability to prevent the need for emergency admissions.

‘Too often people with long term conditions are left to their own devices, without the help, care and guidance that local services should provide.

‘Then something goes wrong and they end up straight back in hospital needing emergency care, at great cost to themselves as well as to the system. Our primary care system has become reactive when it needs to be proactive.’

He added: ‘We need to return NHS primary care to its root purpose – looking after people in the community so they don’t become ill and need to go to hospital, rather than simply acting as a gateway to the system when they do.’

‘Norman Lamb will be announcing shortly plans for local pioneer sites to lead the way on this. I have also asked NHS England to look at the system-wide operational incentives that need to change to make this happen.’

The speech comes as the Department of Health said that it had asked NHS England to review out-of-hours care, and refused to rule out whether this would include considering whether GPs should take back responsibilty for out-of-hours care, as suggested in media reports.

NHS England’s deputy medical director Professor Steve Field also said today that GPs should ‘never have given up the responsibility for out of hours care’, adding to the debate over the pressures on emergency and urgent care services.

Dr Mark Porter, BMA chair, said: ‘The Government’s analysis of where responsibility lies for the huge and increasing pressure on emergency care is completely simplistic. Singling out individual parts of the health service and engaging in a blame game is unhelpful and misses the point.

‘Ministers should be engaging positively with healthcare professionals to improve and maintain services for patients, rather than demoralising NHS staff who are working harder than ever with fewer resources, wherever they are in the service.

‘GPs are undertaking increasing numbers of GP consultations and hospitals are facing similar levels of high demand that is only likely to rise in the years to come, and become more complex as the population grows and people live longer. These pressures are coming at the same time as health budgets contract in real terms.

‘The BMA has written to the Secretary of State asking for an urgent meeting so that we can discuss how we can move forward and tackle the latest emerging crisis facing the NHS.’ Click here to read the full letter.

 Dr Laurence Buckman, GPC chair, said: ‘The BMA has made it clear for many years that the provision of out-of-hours care in England needs to be improved, particularly in how it is resourced and co-ordinated, but it is wrong to blame the GP contract for problems with the system. The Government’s analysis of the problem is extremely inaccurate.

‘Out-of-hours care has historically been badly underfunded even before the introduction of the GP contract in 2004. Despite rising patient demand, funding has remained static in the last few years. The bungled introduction of NHS 111, which was intended to alleviate pressure on the system, has just made matters worse.’