GPC draws line in sand over out-of-hours care

GPs could be expected to take back part of 24-hour responsibility as emerging consortia try to make efficiency savings in urgent care, GP has learned.

Dr Fay Wilson: out-of-hours care quality standards are stringent
Dr Fay Wilson: out-of-hours care quality standards are stringent

Dr James Kingsland, national clinical commissioning network lead at the DoH, said addressing 'spiralling costs and activity' in urgent care was a top priority for many consortia.

But GP leaders warned that asking GPs to provide out-of-hours care was a 'line in the sand that they cannot cross'.

Dr Kingsland said many GPs starting to take hold of commissioning were 'shocked' at the high level of NHS spending on urgent care. 'There is a sense that urgent care is broken and something needs to be done to fix it,' he said.

Dr Kingsland said consortia could shift some services delivered by walk-in centres to practices by building on the extended hours access DES.

Increasing practices' role in urgent care could cut costs by bringing down unnecessary visits to A&E, he added.

'Extended access is usually for pre-booked routine care. It wouldn't take a big step to move that into urgent, unplanned care as well,' he said.

This could allow some walk-in centres to be shut down or to cut staff, he said.

Dr Kingsland stressed that this would not mean GPs have to take back full 24-hour responsibility. 'I don't think it's a case of wanting to opt in, take a few grand back and supply all that is needed in out-of-hours care,' he said. 'It is a bigger process of looking at all of urgent care.'

But GPC negotiator Dr Peter Holden said consortia leads were 'out of touch' if they think GPs would be willing to take on out-of-hours work.

He said: 'If any consortia leads think they can lean on GPs in any way, shape or form to do out-of-hours they will find themselves not elected. This is a line in the sand that they cannot cross. It has to be absolutely voluntary. There can be no pressure on practices.'

Dr Fay Wilson, chairwoman of the BADGER out-of-hours co-op in Birmingham also warned that tough quality standards for out-of-hours care meant it was not a simple task to transfer urgent care work to practices. 'There is quite a distance from thinking about it to executing it,' she said.

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