NHS London leader calls for 'segmented' primary care

NHS England's top official in London has called for primary care to be 'segmented' to meet varying needs of patients.

NHS England: segment general practice

London regional director Dr Anne Rainsberry said the current system was failing to meet the needs of both older patients with long-term conditions and younger, healthier people.

Failure to meet the needs of older people with long-term conditions who want continuity and longer appointments, was causing them to turn up at A&E departments, Dr Rainsberry suggested.

‘A lot of older people with long-term conditions, typically, but not exclusively, aren’t the people who turn up by choice at A&E departments. They would rather use primary care. But the way in which it’s organised doesn’t allow access to that person.’

She added that other groups such as younger, healthier, people and young mothers also found ‘the model of primary care we have…doesn’t meet their needs’.

‘There is a question about how do you segment the primary care offer?,' she said. ‘I think there is something about how we segment the offer depending on what people’s needs are.’

Dr Rainsberry speaking at a Westminster Health Forum conference on urgent care and seven-day services, was supported by GMC chief executive Niall Dickson who said: ‘On general practice, I think there is certainly a case for segmenting the offer.'

House of Commons health select committee chairman, Stephen Dorrell MP (Con, Charnwood) also suggested the current model was not always fit to help keep older people with developing healthcare need out of urgent care services.

Mr Dorrell backed agreement over named GPs but asked: 'Does modern general practice meet that requirement to deliver integrated and developing care and support with medical intervention? Is that what the Bevanite model of general practice is designed to deliver? In some cases it does deliver it. It some cases, it definitely doesn’t.'

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