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Dr Michelle Drage: ‘Communication from hospitals is dire’

GPs will vote with their feet and quit general practice en masse unless the Government urgently addresses the problem of hospitals dumping care on GPs, according to the chief executive of Londonwide LMCs.

In an exclusive interview with Pulse about the results of Londonwide LMCs’ largest-ever survey of GPs in the capital, Dr Michelle Drage said hospital behaviours such as failing to provide adequate discharge information were having a huge impact on primary care.

The solution should involve addressing historic underfunding in general practice and political backing for CCGs to shift funding from secondary to primary care, she said.

‘Hospital behaviours are not enabling the best service for patients,’ said Dr Drage. ‘Where is the hotline for patients who can´t make hospital appointments?
Instead GPs have to do a new referral. Communication from hospitals is dire and results in unnecessary consultations.’

‘Discharge summaries are few and far between and bad when they are. Dumping of prescribing is frequent and frustrating. What this says to me is that people need to stop commissioning for secondary care and commission for primary care.’

‘Trusts are very well organised and good at putting their own interests first - particularly in London - to the point where patients don´t realise what they could have.’

‘There´s a system focus on secondary care, particularly on A&E. No one has thought about the impact on primary care. I think the problem is cultural. There has been at least a three-fold underfunding of primary care compared to secondary care and all of the support we used to have from district nurses and social workers and so on is no longer around.’

‘CCGs do have the wherewithal to make changes to budgets that would make a difference to GPs. Where is the investment in community services and diagnostics? But politically it´s seen as a bad thing if CCGs are trying to take money out of hospitals. The Government needs to take the decision to invest more in primary care.’

‘If not, GPs will walk. There´s a risk of people throwing the towel in at retirement and before and the system becoming totally unworkable. And that´s a failure because general practice provides the most economical way of caring for patients.’

Dr Drage added that the biggest surprise was the level of agreement between GPs about the problems they face.

“It´s getting beyond the tipping point. Ninety and ninety six per cent of GPs agreeing is colossal. It very much tells us what is broken with the system. I hope that [health secretary] Jeremy Hunt is watching, as we´re showing him potential solutions to his problems.’