Not enough GPs for A&E triage plans, says Wollaston

Government plans to put GPs in every A&E by this winter are not possible with the current primary care workforce, the chair of the House of Commons health select committee has said.

Dr Sarah Wollaston (Photo: JH Lancy)
Dr Sarah Wollaston (Photo: JH Lancy)

Former GP Dr Sarah Wollaston warned ministers the GP workforce would not stretch to cover the co-location plans announced by chancellor Philip Hammond in last week's spring budget.

Trusts have been told by NHS England to set up GP-led triage systems at every emergency department in England in time for next winter to help reduce pressure on services. Hospitals are able to bid for a share of a £100m capital funding pot to help with setup costs.

Trusts will be expected to support the new systems from existing budgets and services, including possible reconfiguration of primary care services such as GP out-of-hours care.

GP workforce

Dr Wollaston, speaking in a debate on health and care funding, welcomed the new A&E funding but she warned health minister Philip Dunne: ‘Having a general practice workforce that can fund these co-located departments alongside out-of-hours departments, and alongside proving routine surgeries on Sundays - I'm afraid we simply don't have the workforce to be able to sustain that.’

While the government was committed to increasing the GP workforce, Dr Wollaston added: ‘That is happening alongside a retirement bulge in primary care that is very significant, and I think that something will have to give. I simply don't feel that we have the workforce as it stands to do that.’

Labour MP and public accounts committee chair Meg Hillier, who secured the debate, said the NHS budget announcements, which also included new capital funds for STP implementation, were a 'very small amount' relative to the NHS budget. 'The concern is that it is not long-term and sustainable,' she said. 'A long-term plan is necessary for funding the NHS.'

Mr Dunne said the planned triage systems were proven best practice to divert non-urgent cases at A&E to be seen by GPs or nurse practitioners.

NHS winter pressure

‘This has been proven to work so we are looking to provide some facilities for basic capital spend to ensure that every A&E hospital in the country has streaming in place by next winter.’

GPonline revealed last week that the money could be used to set up temporary premises to house the new triage services and that the government expects local NHS bodies to reorganise existing primary care services to staff the systems.

The BMA has warned that proposals could deepen the crisis in the NHS by stretching the existing workforce and driving more patients to hospitals.

RCGP chair professor Helen Stokes Lampard has GPs should be in their communities. ‘The government must realise that the most severe pressures in A&E are not simply down to inappropriate attendance but the inability to admit seriously unwell patients, and lack of capacity to discharge them into the community.’

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