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Labour would put GP out of hours under ambulance trust control

The Labour Party wants GP out-of-hours services to be put under the direct control of ambulance services as part of its long-term plan for the NHS.

Unveiling the party’s 10-year plan for the NHS earlier this week, shadow health secretary Andy Burnham said the ‘new future’ for ambulance services would include being able to call directly on GP out-of-hours services so as to be able to end the ‘default’ of carrying patients to hospital.

According to Mr Burnham, the plans, which would be consulted upon, promised to be ‘a substantial answer’ to relieving the crisis of too high demand on A&E departments.

He said: ‘I see [the future ambulance service] as an integrated provider of emergency and out-of-hours care, able to treat people where they find them rather than carry them to hospital. This is a substantial answer to relieving the growing pressure on A&E. It is the lack of integration in out of hours care that often results in carrying to hospital as the default option.’

He announced that, if elected, Labour would launch a consultation into how GP out of hours could be ‘integrated’ into the ambulance service, while NHS 111 contracts would be put under the control of ambulance trusts nationwide.

He said: ‘So just as we call for a single team approach in local care, the same principal should apply in out-of-hours arrangements. This is how we do it: As NHS 111 contracts expire, we will look at ambulance services taking them on, so that in time they can handle all 111 and 999 calls from the same call centres. This will mean more experienced staff on the phone and better classification of calls. But just as with other parts of the NHS we need to ask the ambulance service to work from a default presumption of treatment at home, not  hospital, if clinically safe an appropriate.

‘To do this paramedics must be able to call directly on a wider range of health professionals: GPs, OTs, physios, care assistants, who can settle and support people at home in out of hours times before handing over to local teams. Building a sense of a single team [in which] GP out of hours services is essential, all with the financial incentive to keep people out of A&E. So we will consult on better ways in which GP out of hours can be integrated with the ambulance service. These changes will allow us to build a high quality, highly coordinated response behind the NHS 111 number, that commands better public confidence than it has today.’

The plans follow warnings from emergency medicine leaders that the NHS 111 emergency advice line is putting more, rather than less, pressure on A&E departments in its current form. The Government has also highlighted a problem with too many ambulances being dispatched via 999 and has launched a pilot giving call handlers two minutes extra to decide.