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Call for more GPs in A&E to tackle spiralling admissions to ‘overheating’ hospitals

By Gareth Iacobucci

More GPs should be located in A&E departments to try and reverse spiralling emergency admissions costs, a new report from the Nuffield Trust has urged.

The study by the think tank reported a 12% increase in emergency admissions over the past five years, resulting in 1.35 million extra admissions.

The report said the increase was ‘unsustainable', and suggested locating more GPs in A&E settings to try and halt the surge, as well as giving consultants a greater role in deciding whether to admit cases.

It also urged policy-makers to continue to scrutinise and reform systems for reimbursing hospitals and GPs for the care they provide in order to discourage ‘avoidable admissions'.

It advised that this could be achieved by introducing ‘risk-adjusted capitated payments' for GPs and hospital providers for each patient per year, with financial risk borne by the provider and savings from averted emergency admissions ‘shared between both types of provider'.

It also recommended that shorter stays for admitted patients are translated into reductions in the number of hospital beds, rather than further lowering the threshold for hospital admission, and called for ‘higher-quality out-of-hospital care for patients to reduce the need for emergency admissions'.

Nuffield Trust director Dr Jennifer Dixon said reversing the trend was ‘the number one priority for the NHS in England'.

Dr Dixon said: ‘Our hospitals are overheating and are on an unsustainable path in which they are treating patients at great cost to the NHS and to patients themselves. This cost could be avoided by preventing ill health through better care by GPs, community care services or social care, and better co-ordination of care between doctors in hospital and general practice.'

‘Avoidable emergency admissions will continue to rise unless care is more integrated and hospitals and beds are closed. Otherwise the risk is that the NHS becomes unaffordable.'

‘Any reform to the health service that does not tackle this will fail.'

The report called for more GPs in A&E settings to help reduce spiralling admissions The report called for more GPs in A&E settings to help reduce spiralling admissions