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Government to expand GP streaming service as ‘10%’ of A&E patients diverted

The Government is planning to expand GP streaming services in A&E departments after claiming that it reduced pressure on urgent care services, a minister has stated.

Baroness Blackwood, the Department of Health and Social Care’s then-minister for innovation, said that 10% of all patients visiting A&E are now seen by a GP.

Since 2018, acute trusts have had to ensure they have GPs on site at all times to divert and treat patients who do not need hospital care, backed by a £100m investment.

Addressing the House of Lords last month, Baroness Blackwood said: ‘We need to improve access to community care to make sure that people are diverted away from inappropriate visits to A&E. We have said that we will recruit over 6,000 doctors in GP practice, and we are working on that as we speak.

‘We are also increasing the number of GP[s] within A&E so that people can be diverted into appropriate care when they go to A&E inappropriately. The evidence is that already around 10% of those attending A&E are streamed [via] those GP[s], and we are currently trying to increase that provision.’

The Government, which has yet to publish any official evaluation of the scheme, told Pulse the 10% figure comes from internal analysis, which it declined to share in full.

The DHSC and NHS England also told Pulse they had no central data for how many GPs are currently working in A&E streaming as this was managed at a local level.

GP leaders argued that the scheme should not be expanded, as the streaming services create a ‘perverse incentive’ for patients to go to hospital rather than their GP practice and threaten continuity of care.

Dr Fay Wilson, CEO and medical director at Urgent Health UK and GP out-of-hours cooperative Badger, told Pulse: ‘Patients are not thick, it will simply result in more and more people going into A&E. It ends up giving patients a perverse incentive to go into A&E with minor ailments, we need to stop treating them in A&E. It’s a really, really stupid idea.

‘I’m fed up with politicians not looking at evidence, creating kneejerk reaction policies and not responding to the patients’ needs. It is much more sensible to use GPs in general practice, rather than put them in hospitals.

‘I’m sick of the NHS spending £70, £80, £90 to see a single patient in A&E when they are not prepared to properly fund general practice.’

Dr Krishna Kasaraneni, BMA GP committee executive lead for workforce, said: ‘One of the key solutions to addressing the pressures on access to services in the NHS is to invest in expanding the primary care teams in GP practices. With investment to increase the number of GPs and allied health care professionals, the care provided to patients in general practice will continue to improve.

‘This, in turn, should then address some of the pressures on the NHS as a whole. There is no substitute for continuity of care and spreading the already stretched GP workforce even more thinly is likely to further fragment care.’

Early evaluation of the scheme saw researchers on the fence, with one study claiming GPs saw patients ‘quicker’ using ‘fewer resources’, while another failed to show any impact on overcrowding issues.

Meanwhile, a Pulse survey a year into the scheme found that a quarter of GPs were finding it more difficult to employ locums as these were being booked up to work in A&E departments.

Baroness Blackwood resigned as a health minister in last week’s cabinet reshuffle. Meanwhile, Helen Whately, the MP for Faversham and Mid Kent, was added to the DHSC team as a minister for care.