GPs handed urgent care role in bid to tackle A&E crisis

GPs could be handed an expanded role in urgent care under an NHS England support plan to tackle A&E waiting times.

Sir Bruce Keogh: urgent care review underway
Sir Bruce Keogh: urgent care review underway

The plan includes commitments to strengthen GP out-of-hours services and create local urgent care boards that include GPs.

Last month ministers caused outrage among GPs by suggesting the 2004 decision to allow GPs to opt out of 24-hour responsibility was causing pressure on emergency departments.

The announcement by NHS England comes ahead of a review by its medical director, Sir Bruce Keogh, of urgent and emergency care. Sir Bruce is expected to report his findings during the spring.

NHS England said in the last quarter of 2011/12, 47 out of 152 providers failed to meet the 95% standard for patients being seen and discharged within four hours. In the last quarter of 2012/13 this figure doubled to 94 out of 148.

The support plan announced will see NHS England, Monitor and the NHS Trust Development Authority set up urgent care boards of local healthcare leaders, including GPs, covering every A&E department.

The boards will, by the end of May, ensure local recovery and improvement plans are in place for every A&E department. Other health service providers are expected to participate.

Professor Keith Willett, NHS England's national director for acute episodes of care said: ‘What we all want is great service for patients that meets and often exceeds the minimum standards. To get there, we need the whole NHS system, in the community and hospitals, to recognise the problems and help to relieve the pressure on their colleagues in A&E.

‘In the longer term we need to combine all the expertise in the NHS to determine how best to organise emergency care in future so that people get appropriate, effective and rapid care whenever and wherever it is needed.’

The plan will tap into a funds made up from the 70% deduction from fees paid to hospitals for all emergency admissions above a certain limit.

NHS England will also review the ‘levers and incentives’ in the emergency care system.

An urgent care checklist, published by the King’s Fund think tank, is also recommended for use by health services. The list includes recommendations for GP practices and out-of-hours services.

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