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GPs to co-ordinate 24/7 care for the elderly from next year



The GP contract will change to include a responsibility for practices to provide a ‘named GP’ responsible for co-ordinating all the out-of-hospital care for vulnerable older people from next year, the health secretary has announced today.

Jeremy Hunt said that he would seek changes to the GP contract to establish a 24/7 service that ‘pro-actively’ looks out for patients, with the vulnerable elderly the first to be included in 2014.

Mr Hunt said that ‘fundamental change’ was needed to reduce the pressure on A&E departments and would mean more joined-up care, with GPs overseeing primary care, social care and A&E use for all the vulnerable elderly patients on their lists.

Today’s announcement said: ‘Fundamental changes mean joined-up care – spanning GPs, social care, and A&E departments – overseen by a named GP.  Many vulnerable older people end up in A&E simply because they cannot get the care and support they need anywhere else.’

‘These changes will reduce the need for repeated trips to A&E, and speed up diagnosis, treatment and discharge home again, when patients do need to go to hospital.’

The proposals, which are currently being put together, follow their inclusion on NHS England’s review of primary care launched earlier this month.

Mr Hunt said they would include:

  • Patients having a named clinician responsible for the coordination of their care right across the NHS – between hospital, in care homes, and in their own homes. This is subject to on-going engagement, but current views are that a GP should fill this role.
  • Care for older people must be joined up between social care services and the NHS, starting with the £3.8 billion integrated care fund recently announced by the Chancellor.
  • Information and patient records must be shared across the NHS and social care services so that accurate clinical information is available at all times to everyone involved in a patient’s care, and staff can spend more time providing care, not form-filling.  By the end of 2014 at least one-third of A&Es should be able to see the GP records of their patients; and at least one-third of NHS 111 services to be able to see the GP records of their callers.

Mr Hunt said: ‘This winter is going to be tough– that’s why the Government is acting now to make sure patients receive a great, safe service, even with the added pressures the cold weather brings. But this is a serious, long-term problem, which needs fundamental changes to equip our A&Es for the future.

‘In the long term, I want a 24/7 service which recognises patients as individuals and looks out for them proactively.  Starting with our most vulnerable, this Government is going to support the NHS in doing exactly that.’

The DH further outlined how £250m of the £500m extra cash that the DH has promised to tackle the A&E crisis will be used with primary care set to benefit from an additional £25m for district nursing.

GPC chair Dr Chaand Nagpaul said that GPs needed increased time and space to deliver ‘high quality care’ to older people and reduce A&E admissions.

He said: ‘GPs already deliver vital services to older people and manage their care in the community. This involvement makes GPs ideally placed to play a key role in helping to address the challenges that the NHS is facing from an ageing society.

‘Ministers have already acknowledged that GPs are working harder than ever before, but the government must also realise that GP services are stretched to breaking point.

‘GPs need increased time, space and capacity to care for vulnerable older patients. It is only through real investment, support and partnership with healthcare professionals that the NHS will be able to deliver the personalised, high quality care for older people that we all want to see.’

Dr Michael Dixon, chair of NHS Alliance, said he was ‘entirely supportive’ of the plan to introduce a named doctor, but that GPs would need more resources.

He said: ‘If we are going to deliver this new, patient focused agenda we will need to reinvigorate primary care.  There will have to be greater resource in general practice, with, as Mr Hunt has acknowledged, at least 50% of doctors becoming GPs, and we will need to prioritise what’s important, ensuring that we stop doing the unnecessary tasks such as QOF “tick-boxing”, and instead really focus on whole person care.’