King's Fund urges GPs to delegate 'less sick' to nurses

GPs need to spend more time with their sicker patients and delegate the care of the less sick to practice nurses and telehealth, an NHS expert has said.

Speaking after a King's Fund meeting on workforce on Thursday, Candace Imison, deputy director of policy at the King's Fund, said it was important for GPs to think more ‘creatively’ about how they care for patients with varying needs.

Ms Imison said it was ‘absolutely within GPs’ remit’ to take control of their workforce and use systems such as telephone triage to establish which patients need the most urgent care and which could be seen by a nurse or have a telephone consultation.

She said: ‘There are ways of looking at the workload that general practice has to manage and putting the GP workload more clearly aligned to their sickest patients, their patients with greatest needs and then using nurses and healthcare assistants to manage the more routine needs of patients.’

Ms Imison said GPs in the UK could learn from general practice in the US where people with chronic disease are seen for longer by their GP and nurses, telephone consultations and email consultation are used to deal with the ‘less sick’ patients.

She said that there was a lot of work yet to be done in general practice in the UK on how it manages ‘those two big dimensions of its workload’.

‘We could be using the workforce differently. It is already happening; we have seen the number of consultations undertaken by nurses (in general practice) has gone up two fold in the last period.’

Ms Imison added that it was crucial for general practice to relate better with specialists, to ensure that chronically ill patients who need intensive support are kept out of hospital.

‘We need more specialist input into general practice while we need more generalist input into secondary care,’ she said.

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