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Out-of-hours GPs ‘should be based in A&E departments’

GP out-of-hours services should be based in every A&E department, according to joint recommendations from the College of Emergency Medicine and three other royal colleges.

In their Acute and emergency medicine: prescribing the remedy report, the colleges say it’s ‘unreasonable’ to expect patients to determine whether their illness is a serious or minor condition and co-locating A&E and OOH would allow patients to attend one facility and be ‘streamed’ to the appropriate service following triage.

However the BMA has said the scheme could overwhelm an already overstretched GP workforce, and prevent patients getting ‘care they need in the community’.

The report states: ‘It is unreasonable to expect patients to determine whether their symptoms reflect serious illness or more minor conditions. Co-location enables patients to be streamed following a triage assessment.

‘This also enables collaborative working including sharing of diagnostic facilities, reduces duplication of administrative tasks and permits patients to be easily re-triaged should further assessment require so.’

This is one of 13 recommendations by the Royal Colleges of Physicians, Paediatricians, and Surgeons, which also calls for an end to the four-hour A&E target, and for seven-day delivery of community and social care services.

However, GPC chair Dr Chaand Nagpaul explained that, although the scheme could have benefits, the priority should be to ensure there are ‘sufficient’ numbers of GPs coming through general practice’s doors to prevent A&E admissions.

Dr Nagpaul said: ‘Strengthening the link between GPs and hospitals could deliver real benefits to patients by ensuring that they get fully joined up care.’

‘However, general practice is suffering from severe workforce pressures.’

The president of the College of Emergency Medicine, Dr Clifford Mann, said it would be a ‘scandal’ if these consensus recommendations were ignored by policy makers.

He said: ‘If we are to avoid an annual crisis and build a resilient system it is vital that the 13 recommendations within this unique document are implemented.’

‘No plans for acute and emergency care should be developed without reference to these consensus recommendations. It would be nothing short of a scandal if these recommendations were not acted on. The time for action is now.’

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