Urgent care integration threatened by constant change, warns RCGP

'Constant change' in the NHS is undermining integration, RCGP chairwoman Professor Clare Gerada has warned MPs.

Professor Clare Gerada: change has undermined NHS
Professor Clare Gerada: change has undermined NHS

Speaking to the House of Commons health select committee's emergency care inquiry, Professor Gerada said there were good examples of urgent care services run by integrated primary and secondary providers, and that ‘the will is there’ to join up different parts of the system.

But the development of such services was hampered, she said, by the ‘ever changing landscape’ of the health service, and differences in commissioning arrangements.

‘Dare I say that no sooner does one form relationships with the commissioners and the providers across the system, than the faces change. That does cause huge organisational difficulties, when the burn of developing these kinds of services can be a year or two years and if you’ve got an ever changing landscape it become very difficult.’

Professor Gerada warned MPs that general practice was under similar pressures to emergency care, and had seen a 100% increase in workload over the past decade.

She said many practices were now fully booked by 8.30am, and that her own practice was seeing queues down the street not seen since the height of the bird flu pandemic.

It was ‘disgraceful’, Professor Gerada told MPs, that unless it was a ‘dire emergency’, patients could not get a same-day appointment.

‘This is not because GPs are going playing golf in the afternoon,' she added. ‘This is because they are working 15-hour days trying to respond.'

She said: ‘Change produces confusion, change means you have to rebuild relationships, change means you find bits that were running well, stop running well.'

However, CCGs provided an opportunity to commission more integrated services, said Professor Gerada, and she called for a ‘whole system approach’ to the pressures on emergency and primary care.

Watch Dr Gerada's select committee appearance (starts at 10:47:25)

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