Health secretary Jeremy Hunt has announced that older patients with complex health needs will be assigned a single ‘named clinician’ accountable for their care at all times when they are out of hospital, and has suggested this should be their GP.
Mr Hunt said that the move was intended to drive forward better-integrated, coordinated out-of-hospital care, ensuring ‘patients and relatives have a single point of information and responsibility for their care’.
But the announcement has been met with bemusement by GP leaders, who said that GPs already were responsible for their patients out of hospital.
The announcement marked the the 65th anniversary of the NHS and a major public consultation on a raft of new proposals to ‘refresh’ the NHS Mandate and improve the care of elderly people.
The proposals include developing new recommendations ‘to extend GP choice’, applying the ‘friends and family test’ to practices by the end of 2014 and improving access to primary care through the greater use of technology and ‘rapid walk-in access’.
But in a speech today, Mr Hunt chose to focus on a proposal to have a ‘single, named contact to coordinate an individual’s care’.
He explained: ‘We need to know that there is a clinician accountable for vulnerable older people in the community just as there is a consultant responsible for them in hospital.
‘As a member of the public I would like that to be my GP - but whoever it is they should be named so that patients, families and carers all know where the buck stops.’
NHS England will be asked to have named clinicians for elderly patients with complex health needs in place from April 2014, with the proposals a key plank of the new NHS Mandate for next year. Mr Hunt said that he hoped named clinicians would cover every patient in due course, although he did not offer a timescale for this expansion of the scheme.
The Department of Health said that they would seek views on their proposals to improve the care of older people over the summer and a plan would be produced to implement them with NHS England in the autumn.
A spokesperson said: ‘The final plan will be published in October and will be reflected in the refreshed mandate to NHS England for 2014 to 2015.’
Mr Hunt first floated the ‘named clinician’ proposals at a King’s Fund conference in May and the Government has earmarked £3.8 billion for better care integration and helping older people out of hospital in its recent spending review.
Speaking to Pulse, GPC chair Dr Laurence Buckman said he was ‘puzzled’ by the announcement as every patient already has a named GP.
‘He’s announced it repeatedly, we don’t know what it means. We’re going to be talking to Government officials to find out,’ Dr Buckman said.
‘Every patient already has a named GP. GPs are responsible – I don’t know what he thinks this means.’
RCGP chair Dr Clare Gerada said that the RCGP welcomed the emphasis on GPs’ central role in delivering care for the vulnerable, she had reservations about what the Government is really intending and where the money will be spent.
She said: ‘We’re terribly worried that this will mean £3.8 billion going into the private sector – that it will be a tendering process led by the corporate healthcare providers, the likes of Virgin who will set up integrated care organisations that will employ GPs but will be separate from general practice and will end up being money being siphoned away.’
‘Rather than that we think this should be directly invested in primary care. We have the best integrated care in the world – it’s called the general practice and multidisciplinary care team. If we build on that, if this £3.8 billion comes into primary care, we will deliver the best integrated services for our vulnerable elderly people as well as continue to provide care for everybody else.’