The chair of the RCGP has issued a strongly worded statement saying there is ‘no evidence’ to support the health secretary’s claims that GPs are responsible for rising attendances at A&E departments.
RCGP chair Dr Clare Gerada, said GPs were being ‘used as a scapegoat’ and that it was not acceptable for Mr Hunt to claim that the rise in demand on A&E services was due to a reduction in out-of-hours provision by GPs.
She added that there was no evidence that the 2004 GP contract was as ‘disastrous’ as ministers have claimed recently, and pointed out that A&E attendance figures are calculated differently from a decade ago, throwing into doubt their claims that four million additional patients attended due to out-of-hours failings.
The unusual intervention from the college comes as BMA chair Dr Mark Porter called for urgent talks with Jeremy Hunt over his claims that ‘innaccessible primary care’ was to blame, saying he was ‘engaging in a blame game’ that was unhelpful and ‘misses the point’.
In a major policy speech yesterday, the health secretary announced plans 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.
Mr Hunt 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.
He also reiterated his claim 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’.Click here to read the full speech.
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.
Dr Gerada questioned said: ‘Once again, GPs are being used as a scapegoat and it is not acceptable.
‘It is not true that the rise in demand on A&E services is due to a reduction in out-of-hours provision by GPs - and there is no evidence to prove that the increase is due to the GP contractual changes in 2004. We acknowledge that there has been a gradual rise in the numbers of patients attending A&E since 2004, but the numbers are calculated differently to a decade ago and now take into account attendance at walk-in centres and minor injury units.
‘There are numerous reasons why our colleagues working in A&E departments are under pressure. As well as a serious shortage of A&E consultants, the lack of co-ordination between health, community and social care - particularly in the care of frail elderly patients - leads to a myriad of problems including unnecessary admissions, breaches in the four-hour target and delays in ambulance turnaround.
‘We must stop assuming that the health service starts and ends with hospitals. Nor should we assume that increased demand equates to bad outcomes. Over the last decade, a number of initiatives have been put in place to improve access to timely and appropriate care.
‘We are one NHS with patients accessing different services at different times - be it their GP surgery, walk-in clinics, pharmacy, NHS 111, or minor injury units, as well as hospitals. Focussing on A&E departments misses the bigger picture and does great disservice to the people working across the NHS who are trying to do their best for all their patients.
‘These are tough times for us all and one of the issues Mr Hunt should be addressing is the shortage of 10,000+ GPs across all services, not just out-of-hours.
‘As a national health service we should all be working together with Government to improve patient care, not blaming GPs for perceived ‘inadequacies’ in patient care.’