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Primary care blamed for A&E wait increase

29 April 2013

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Health Secretary Jeremy Hunt has said increased demand for A&E services was caused by poor out of hours care.

Late last week the Health Secretary claimed “inaccessible primary care” is to blame for the rising pressure on emergency care. 

He said GPs have become a “gateway to hospitals” and should return to the “root purpose” of looking after patients in the community. 

However, Royal College of General Practitioners (RCGP) chair Dr Clare Gerada issued a statement that said there are “numerous reasons” why A&E departments are under pressure.  

‘Completely simplistic’ 

She said: “It is not true that the rise in demand on A&E services is due to a reduction in out of hours provision by GPs. 

Listing the reasons why Accident and Emergency departments might be under pressure she said: “The lack of co-ordination between health, community and social care –  particularly in the care of frail elderly patients – leads to a myriad of problems including unnecessary admissions, breaches in the four-hour target and delays in ambulance turnaround.” 

Dr Gerada urged the NHS to work together to improve patient care “not blame GPs for perceived ‘inadequacies’ in patient care.” 

Chair of the British Medical Association (BMA) Council Dr Mark Porter believes blaming general practice “misses the point.” 

He said: “GPs are undertaking increasing numbers of GP consultations and hospitals are facing similar levels of high demand that is only likely to rise in the years to come, and become more complex as the population grows and people live longer.

“The Government’s analysis of where responsibility lies for the huge and increasing pressure on emergency care is completely simplistic.” 

NHS 111 rollout

And Dr Laurence Buckman, chair of the BMA’s GP Committee said the government’s analysis of the problem was “extremely inaccurate.” 

He said: “Out-of-hours care has historically been badly underfunded even before the introduction of the GP contract in 2004. Despite rising patient demand, funding has remained static in the last few years. 

“The bungled introduction of NHS 111, which was intended to alleviate pressure on the system, has just made matters worse.“

The NHS Alliance believes the NHS 111 ‘fiasco” enforced unnecessary guidelines before consulting with the frontline. 

Rick Stern, chief executive of the NHS Alliance and its urgent care lead, said: “The confusion, delays and frustration caused by the botched procurement and introduction of NHS 111 is not the fault of general practice or primary care. 

“Blame, especially on a GP contract introduced nine years ago, will not help us put this right for patients”.

The Alliance has called for a “period of reflection” for NHS England, the Department of Health, primary care and urgent care to work out a realistic way forward for non-emergency care number NHS 111.