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GP-in-A&E scheme will not be sustainable in the longer term, hospital leaders warn



Hospital bosses have warned that they will not be able to sustain the new ‘GP streaming’ services in A&E beyond next winter unless the Government puts more cash into the scheme.

NHS Providers, the representative body for trusts, said that the likely continued cost of the scheme will between £500,000 and £1m per hospital, each year – resources which NHS trusts simply do not have to spare.

The Spring Budget pledged £100m to set up the service across England before next winter, but the Treasury has made no mention of ongoing funding for the scheme, which NHS bosses hope will reduce unsustainable pressure on emergency departments.

The report said: ‘Many trusts currently do not have this kind of surplus to support this initiative, and it will require funding from commissioners.’

Simon Stevens, chief executive of NHS England, has previously said that every A&E should have a GP streaming service in place ‘by Christmas’ in order ‘to avoid a repeat next winter of this past winter’.

But NHS Providers said even with £100m being allocated this year, this was unlikely to be used ‘quickly enough to make a tangible difference this winter’.

Dr Richard Vautrey, deputy chair of the BMA GP committee, said: ‘The best way to support patients this winter is to invest properly in general practice and community services, as well as developing a much better self-care programme to empower and give confidence to patients.

‘Not [by] spending even more money on setting up a service in A&E that simply acts as a magnet to draw in more patients to hospital-based services.’ 

The report also noted the ‘substantial workforce constraints’ limiting trusts’ ability to roll out the GP streaming service ‘when there are already shortages in core primary care services’. 

A Pulse investigation in April found that the NHS would need to find an extra 400 GPs to deliver the plans and Pulse revealed earlier this month that NHS England has instructed hospital trusts not to pay GPs more than £80 per hour.

The NHS Providers report also included a survey of hospital bosses, which found that more than nine out of ten (92%) of them expect the lack of capacity in primary care to impact their hospital’s ability to cope with winter demands.

NHS Providers chief executive Chris Hopson said: ‘Last winter NHS staff responded heroically to extraordinary pressures. But safety and standards of care were compromised.

‘In too many places the NHS was overwhelmed for short periods of time. We must not allow that to happen again.’

The Department of Health has so far allocated £77m out of the pledged £100m funding to 97 trusts for the GP-in-A&E scheme.

It comes as last winter a majority of hospitals consistently broke the national target to treat patients in A&E within four hours.