GPs fear workload rise as NHS looks to push patients out of hospital faster

NHS plans to shorten hospital stays for tens of thousands of people could increase pressure on GPs and put patients at risk, GP leaders have warned.

Hospital discharge (Photo: sturti/Getty Images)
Hospital discharge (Photo: sturti/Getty Images)

The Where Best Next? campaign, which encourages hospital staff to 'take practical steps every day to help get patients closer to a safe discharge', was introduced by the NHS this week with the goal of freeing up more than 7,000 beds a year.

The scheme, which NHS England says could free up capacity equivalent to 'building an extra 15 hospitals', aims to cut hospital stays to below three weeks for around 140,000 people.

Hospital staff will be reminded through posters and other sources to think of a ‘home first’ approach to care planning, to move patients home or to a community care setting earlier. They will also be encouraged to tell patients about the benefits of returning home at the right time as one of five guiding principles of the campaign.

GP workload

But BMA GP committee chair Dr Richard Vautrey has said that any attempts to speed up the rate at which people return home will place additional strain on GPs and other healthcare professionals without adequate resources to bolster the primary care workforce.

He said: ‘We know our colleagues in hospitals are struggling with a vast shortage of beds – with the BMA estimating that 10,000 more are needed to bring capacity to safe levels – and of course no doctor wants patients to spend longer than they have to in hospital.

‘However, efforts to reduce lengthy stays and avoid delays in transfer of care will only truly work with proper investment in community and primary care.

‘Without this, it only places greater burdens on GPs, practice staff and hospitals if patients are forced to return, and is not fair on the many vulnerable patients doctors are working hard for.'

Hospital stays

Despite significant improvements to the delayed transfer of care figures, which measure the number of extra days someone spends in hospital after the have been declared medically fit to leave, NHS leaders continue to focus on reducing the amount of time people spend in hospital.

However, concerns remain that this emphasis on getting patients out of hospital doors quicker could increase workload for GPs as patients who have not properly recovered or require additional care visit their GPs when they have left hospital.

Statistics from NHS Digital show that emergency readmission rates for hospitals in England are already on the increase. Between 2013/14 and 2017/18, official figures showed that readmission rates rose from 12.5% to 13.8%. In some of the most deprived areas, the readmission rate is as high as 14.9%.

GPs have long voiced concerns over hospital policies that add to workload in primary care. GP leaders have said in the past that work dumped on practices by hospitals wastes around 15m appointments a year - more than 4% of all consultations provided annually in England.

Hospitals have been accused of ignoring contract clauses that ban them from automatically sending patients who miss appointments back to their GP, or passing patients on to other departments without first requiring a further GP appointment.

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