'Never full' practices key to A&E crisis, says top GP

Practices should be prepared never to turn patients away during core hours, to help solve the urgent care crisis, a GP commissioning leader has said.

Dr James Kingsland: practices must never turn patients away
Dr James Kingsland: practices must never turn patients away

National clinical lead for the NHS Clinical Commissioning Community, Dr James Kingsland, said the solution to increasing pressure on emergency and urgent care services could only come through demand management in general practice.

‘Meeting demand by just improving capacity - building walk-in centres, NHS 111, NHS Direct, minor injuries units - is not the solution,' Dr Kingsland told the Health+Care 2013 conference in London on Thursday.

‘Part of the solution is investment in primary care, particularly general practice - the primary care home, to allow the expansion and finishing of more episodes; making more and buying less for patients.’

Dr Kingsland said evidence from patient access programmes showed triage systems that used GPs as the first ‘port of call’ cut face-to-face time, freeing up resources and increasing capacity to deal with urgent care by around a third.

He said rapid response to home calls would reduce the likelihood of a ‘blue-light’ call.

Around 80% of urgent care demand is during GP core hours, explained Dr Kingsland, so ‘never full’ practices, which never turn a patient away reduce pressure on urgent care services.

‘My practice is one of a number that says we are never full. So that between our opening hours, no patient is ever turned away.’

‘We found that by having a never full practice, the number of calls made between 7am and 8am, to GP OOH, and between 6.30pm and 9pm, for a practice population of 5,000, is just one call every four weeks.’

He said resources were released with fewer staff required in out-of-hours time.

The Royal College of Physicians’ Future Hospitals Commission lead fellow, Professor Timothy Evans, said integration between general practice and acute care was the solution.

’I don’t know where general practice stops and secondary care - escalation of care - starts,’ he said. ‘We need an integration of the two. We need to bring together general practice and hospital care.

'We need far more hospital specialists working to support general practitioners in specialist clinics. And we need far more access points to the service that are coordinated and facilitated by excellent IT.’

‘It’s not hospitals, it’s not general practice, it’s both,’ he said.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

No plans to impose face-to-face GP appointment targets, Hancock tells BMA

No plans to impose face-to-face GP appointment targets, Hancock tells BMA

The government has no plans to impose face-to-face appointments targets on general...

Coronavirus: Key guidance GPs need to know about COVID-19

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

COVID-19 variants could force UK to revaccinate over next 2-3 years warns CMO

COVID-19 variants could force UK to revaccinate over next 2-3 years warns CMO

The UK's chief medical adviser has warned that new coronavirus variants may force...

BMA condemns 'fundamentally flawed' £20m weight management enhanced service

BMA condemns 'fundamentally flawed' £20m weight management enhanced service

The BMA has condemned a £20m weight management enhanced service as 'fundamentally...

GP contract update delivers extra PCN cash and £50m for new enhanced services

GP contract update delivers extra PCN cash and £50m for new enhanced services

An update to the GP contract agreement for 2021/22 has set out details of enhanced...

CQC rejects call for independent review to look at BAME bias in ratings

CQC rejects call for independent review to look at BAME bias in ratings

The CQC has rejected calls for an independent review of its ratings process to look...