GP contract 'not to blame' for A&E pressure, NHS leaders say

Senior NHS figures have dismissed health secretary Jeremy Hunt's claims that the 2004 GP contract is to blame for pressure on A&E.

Mike Farrar: GP contract not to blame for A&E pressure
Mike Farrar: GP contract not to blame for A&E pressure

Mr Hunt has repeatedly said the ‘disastrous’ 2004 deal that allowed GPs to opt out of 24-hour responsibility for patients was behind a rise in A&E attendances.

But experts say his analysis is incorrect, and called for further investment in primary and community care.

NHS Confederation chief executive Mike Farrar gave evidence to a House of Commons health select committee inquiry into emergency services and emergency care on Tuesday.

Speaking after the evidence session, he said: ‘With specific regards to the contractual arrangements for GP out-of-hours care, we do not see a correlation between the changes to the 2004 GP contract and the NHS four-hour waiting standard for A&E departments.

‘In fact for the vast majority of the last decade, A&E waiting time standards have been improving. It is in recent years where the pressures have started to bite, and there have not been any discernable structural changes to out-of-hours GP contracts during that time.’

His comments were echoed by King’s Fund health policy expert Nigel Edwards. Mr Edwards told the BBC's Newsnight programme on Tuesday evening: ‘We’ve seen a long-term trend in increases in A&E attendances. People seem more willing to go to A&E now instead of caring for themselves.

‘We’ve made it easier – people wait a lot less time now. And of course the population is ageing and has more long-term conditions. But we’ve seen no impact whatsoever really from the new GP contract.’

Mr Edwards blamed rising pressure on ‘supplier-induced demand’, with the opening of walk-in centres and urgent care centres creating more demand in the same way that ‘opening a road seems to create more traffic’.

Mr Farrar added: ‘It is clearly evident that there are rising pressures on the whole system. We agree there is a need to improve the coordination of out-of-hours care, and see how it can help take the pressures off A&E.

‘We believe real and lasting improvements to out-of-hours care are possible, but only if we put a greater level of investment in to primary, community and social care.’

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