GPs reject 2004 contract link to rise in child emergency admissions

GP leaders have dismissed research suggesting a link between the 2004 GP contract and a rise in avoidable emergency admissions for children.

A&E: rise in admissions after 2004 not linked to contract, say GPs
A&E: rise in admissions after 2004 not linked to contract, say GPs

Researchers from Imperial College found that the 2004 contract – which allowed GPs to opt out of 24-hour responsibility and introduced the QOF – coincided with an 8% rise in short stay admissions for ‘potentially avoidable chronic conditions’.

Children admitted to hospital with chronic conditions such as asthma and diabetes rose 8,500 a year immediately after the policy changes, the study found.

But GPC deputy chairman Dr Richard Vautrey said: ‘This research ignores the important fact that since 2004 there has been a substantial increase in pressure on the NHS from rising patient demand, falling resources and staff shortages that have particularly affected general practice.

GP out-of-hours funding

‘Funding for out-of-hours services has flatlined over the past decade despite increasing workload. We have returned to the situation we faced a decade ago, with services under unsustainable pressure.

‘Walk-in-centres, NHS 111 and simplistic but counter-productive A&E waiting targets have failed completely to manage and reduce demand on NHS services, including general practice.’

RCGP chairwoman Dr Maureen Baker warned: ‘This research is largely based on ungrounded assumptions - there is no evidence to suggest a causal link between out-of-hours GP access and either increased emergency attendances or short-stay admissions for children.

A&E target

‘Any increase is most likely due to some hospital doctors taking a more cautious approach to admitting children for overnight observation, a response to pressure to meet the A&E four-hour target, and a lack of ability to discharge patients back into the community.’

Dr Baker added: ‘It is a myth that GPs do not work outside of normal working hours – and in an emergency, patients will always have access to a family doctor.’

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