Re: Doctors’ leader calls on Hunt to stop using GPs as scapegoats
GPs see about 300 million people per year and I suspect offer about 50 million telephone consultations. OOH GP (yes we still do this) see about 10 million people per year (and ? about another 10 million advice calls) A/E? See about 15 million per year. GP work load increases by about 3% per year, a/e workload by about 1% per year but there is a huge increase in people with multiple complex problems that need sorting.
Prior to the nhs contract change and post the contract change most GP ooh work was done by GPs working with a local co-op or deputising service. GPs pay about £6000 per year each for forgoing ooh responsibility. The initial contract change did nothing very much except change who paid the ooh bills.
It is impossible to provide one's own ooh under current nhs rules even if one wanted to and felt it was safe to work a standard 11 hour day then be up 4 or 5 times at night and work the next day.
A/E chaos seems as an outsider to be due to 111 introduced by central nhs managers, though nobody is owning up. Now, as predicted, this converts about 13% of calls to 999 (GP ooh services convert 3%). People are fed up with 111 not answering so are going to a place they know-- a/e.
A/E have no beds to put people in as some enlightened planners felt people could be looked after in the community, despite not providing any evidence or resource for this. Kaiser Permanente seems to have a major part in this policy. Telehealth also being rolled out, despite evidence of no benefit and as this week's leader adds high input to the frail in the community also does not prevent admissions.
So the solution--possibly not likely to come from the latest health adviser appointed to No 10 from Circle.
But yes primary care can and should do much better in providing sensible access to people at times that fit in with their work.
Rapid Response:
Re: Doctors’ leader calls on Hunt to stop using GPs as scapegoats
GPs see about 300 million people per year and I suspect offer about 50 million telephone consultations. OOH GP (yes we still do this) see about 10 million people per year (and ? about another 10 million advice calls) A/E? See about 15 million per year. GP work load increases by about 3% per year, a/e workload by about 1% per year but there is a huge increase in people with multiple complex problems that need sorting.
Prior to the nhs contract change and post the contract change most GP ooh work was done by GPs working with a local co-op or deputising service. GPs pay about £6000 per year each for forgoing ooh responsibility. The initial contract change did nothing very much except change who paid the ooh bills.
It is impossible to provide one's own ooh under current nhs rules even if one wanted to and felt it was safe to work a standard 11 hour day then be up 4 or 5 times at night and work the next day.
A/E chaos seems as an outsider to be due to 111 introduced by central nhs managers, though nobody is owning up. Now, as predicted, this converts about 13% of calls to 999 (GP ooh services convert 3%). People are fed up with 111 not answering so are going to a place they know-- a/e.
A/E have no beds to put people in as some enlightened planners felt people could be looked after in the community, despite not providing any evidence or resource for this. Kaiser Permanente seems to have a major part in this policy. Telehealth also being rolled out, despite evidence of no benefit and as this week's leader adds high input to the frail in the community also does not prevent admissions.
So the solution--possibly not likely to come from the latest health adviser appointed to No 10 from Circle.
But yes primary care can and should do much better in providing sensible access to people at times that fit in with their work.
Competing interests: No competing interests