Care and support minister Mr Lamb said that making named GPs responsible for the 24-hour care of the vulnerable elderly – currently under negotiation with the GPC – would be ‘widely welcomed by the profession but also, critically, by the public’.
He told GP that doctors want ‘that sense of responsibility’.
Mr Lamb spoke to GP ahead of the government’s announcement of 14 ‘integration pioneer’ schemes in England on 1 November. The government hopes that other areas will copy the integration pioneers to access a share of a £3.8bn integration fund available from 2015/16.
Models of integration and multidisciplinary teamworking explored at pioneer sites could support GPs taking on 24-hour responsibility for patients, Mr Lamb suggested.
Asked about plans to make GPs responsible around the clock for vulnerable elderly patients, he said: ‘The impression I get is it is what doctors themselves want, I think they want that sense of responsibility for the patients and it links perfectly in with this teamwork approach that I describe. I think it will be widely welcomed both by the profession but also critically, by the public.’
Patients in a pioneer scheme in north west London are given a named individual as a point of contact for teams that include GPs and other community practitioners. Another in South Devon and Torbay has primary mental health workers in GP practices.
In Greenwich more than 2,000 hospital admissions were avoided over two years after a multi-disciplinary team made up of nurses, social workers, occupational therapists and physiotherapists started responding to emergencies.
Commissioners would have to make more ‘rational’ use of the resources otherwise the NHS is heading for bankruptcy, Mr Lamb said.
Mr Lamb said he was 'gobsmacked’ that the DH received 99 bids from would-be integration pioneers. But he said that in too many areas services remain 'horribly fragmented’.
‘It leaves GPs totally frustrated,’ he said.
‘When they know they have access, easy access - critically - easy access to the social worker, to the care worker, to the district nurse, then everything becomes easier. It becomes easier and more fulfilling to the professional but critically it improves care for the patient.’
On the lack of investment in primary care, Mr Lamb said: ‘I realise that the money is tight. That in a way is what provides the imperative for change. Quietly we all know that if we try to carry things on in the traditional way, then we will provide poor care too often and the system will collapse.
'It will bankrupt the NHS, because of rising demand and no more money available. This is not a party-political thing. Any government of any political persuasion faces exactly the same challenge - there’s not a whole lot more money to throw at the system.’
