GPs need support to make 'difficult decisions' about hospital closures

GPs will need training and support to make the 'difficult decisions' about hospital reconfiguration and closures when they take on commissioning, the National Association of Primary Care (NAPC) chairman has said.

Dr Marshall: 'It would be really helpful if there was a national understanding that there are going to be some difficult decisions and how we go about making them.'
Dr Marshall: 'It would be really helpful if there was a national understanding that there are going to be some difficult decisions and how we go about making them.'

Talking at a fringe event on the NHS at the Conservative annual conference in Manchester on Sunday, Dr Johnny Marshall said if services improve in the community it will inevitably mean some hospitals may have to reduce their services or close.

He said it is important GPs talk to local authorities and the public ‘at an early stage’ about their decisions to close hospitals.

But he said although GPs are used to talking with patients about difficult situations, some may require extra support or training to ensure local patients and politicians are behind the changes.

He said: ‘As healthcare improves and people can be looked after in the community …we will have to be looking at how we can reconfigure services and that may mean some hospitals will not have enough throughput to exist as they are.

‘We [GPs] are going to have to make some difficult decisions, I’m sure. I think it would be really helpful if there was a national understanding that there are going to be some difficult decisions and how we go about making them in the best way’.

It comes as Dr Marshall said clinical commissioning groups (CCGs) need to be looking at options for commissioning support separate from that offered by PCTs.

He said CCGs should consider the benefits the voluntary and commercial sector could bring to ensure there is ‘real added value’ to commissioning.

He said: ‘If you do what you always do you will get what you always get. It seems to be that there would be added value for PCTs and CCGs to look outside to see how other organisations could help them [in commissioning].’

Dr Marshall also said it is unlikely GPs will have to carry out all the back office functions of commissioning, and instead get ‘experts’ in to help them.

He said: ‘Every GP I talk to says: "I want as much help as I can with this". It is a steep learning curve but GPs don’t have to do everything. They don’t have to be the accountants or the healthcare managers.

It is really important that they working together with the experts to get the best out of the system… because I think we all realise we cannot do this on our own.’

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