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One million patients to receive ‘personalised’ GP care, says health minister



One million elderly patients will benefit from a ‘personalised and proactive GP service’ from next year under the Government’s plans for a ‘named GP’ to take overall responsibility for their care, says a health minister.

Care minister Norman Lamb said that the plans – announced yesterday – would place GPs in a position of accountability for ‘all aspects’ of their care and would include the frail elderly as well as those with mental health problems.

He added that a separate care coordinator would work alongside to ensure that the elderly do not ‘fall through the cracks’ and that this would form the first part of a three-pronged ‘Vulnerable Older People Plan’ which the Government will roll out in a bid to ensure that the NHS can provide a sustainable service as this group grow rapidly in numbers.

The health secretary Jeremy Hunt said yesterday that the GP contract will change to include a responsibility for practices to provide a ‘named GP’ responsible for co-ordinating all the out-of-hospital care for vulnerable older people from next year

Speaking at the DH’s ‘Vulnerable Older People Plan’ engagement even in London on Wednesday, Mr Lamb added more detail to the plans, saying they were important to ensure that patients know that someone has overall responsibility and accountability for their care.

He said: ‘It is not acceptable for an older person to be shunted from one institution to another, sometimes falling through the gaps in between with no one ultimately taking overall responsibility for their care.

‘So about one million older people, with the most complex health needs, will get a personalised, proactive GP service which will include first of all a GP overseeing all aspects of their care.

‘That doesn’t mean doing everything but overseeing, ensuring that they are treated as a person and not just a set of conditions, and looking to see where improvements can be made and that these are properly followed up. Secondly, a separate care coordinator who will work with a range of experts to ensure that the plan is delivered.’

He added that the Government’s ongoing project to better integrate health and social care and the creation of a shared electronic care record would also improve elderly care.

Mr Lamb said: ‘We have created a £3.8bn transition fund for 2015/16 as part of the spending review to join up health and social care. You may think that is a long way off, but we are expecting every area of the country to start their planning now.

‘Some areas are well on the road, but others are simply not making the progress that is necessary, still working in silos, still allowing people to fall through the gaps in an unacceptable way.’

But GP leaders at the event said the reforms would only be possible if the Government funded an expansion of general practice and reduced bureaucracy in practices’ day-to-day work.

NHS Alliance chair Dr Michael Dixon said: ‘It seems to me that this is a real chance for a renaissance of general practice, for the service to focus on people rather than diseases and move away from the tick-box culture of the QOF and get back to our values and our professional roots.

‘Reseach [has shown] that if you want to improve health and reduce costs you have to invest in primary care. Successive Governments have failed to do that, so this is a move exactly in the right direction.’

Meanwhile, NAPC chair Dr Charles Alessi, who was also on the panel, called for a system-wide reorganisation of payment systems within the NHS, arguing that hospitals cannot continue to be paid by results while general practice received capitation-based payments – drawing spontaneous applause from Mr Lamb.

He said: ‘One of the most important things [that we need to do] is to manage the currencies better, because we still have a system which is capitated around primary care while it is wholly activity based in hopitals and having that system is completely illogical and nonsensical. That needs to be managed, and needs to be managed now.’

Meanwhile, members of the audience questioned how single-handed GPs would be able to oversee all aspects of care for all of their patients. Mr Lamb responded that he ‘shares the concern’ but did not elaborate on how the DH plans to tackle this obstacle to their plans.