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dinsdag 7 februari 2017

RCGP: Shifting workforce pressures from one area of the NHS to another isn't a long term solution, says RCGP

Shifting workforce pressures from one area of the NHS to another isn't a long term solution, says RCGP

"Paramedics are hugely valued and trusted colleagues – but the job of a paramedic and the job of a GP are completely different, and involve different skills and training.

"In some cases, paramedics are already working really well as part of the general practice team where their expertise in, for example, attending to patients who need an emergency visit, is invaluable – but they are not GPs.

"GPs are highly trained to take into account the physical, psychological and social factors that might be affecting a patient's health when making a diagnosis and recommending treatments tailored to that patient in a holistic way – this unique skill set cannot be replaced by another healthcare professional, however well meaning the intention is.

"We do not have enough GPs in the NHS – and actually we don't have enough paramedics either. This transference of workload pressures from one area of the health service to another is not going to benefit our patients in the long term.

"What we do need is for the governments in all four nations of the UK to pull out all the stops to ensure we have enough GPs, and other members of the practice team, to keep our service sustainable and our patients safe for years to come."


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RCGP response to new GP contract

"But these changes to our annual contract must not be seen as a lever to make hard-pressed GPs compromise their own welfare and patient safety by forcing them to be open at times which might be impractical and unrealistic for their particular local circumstances.  

"Smaller practices might need to close temporarily to allow GPs to make home visits, for example, or for their teams to undertake mandatory training. We need to see very clear guidance about when closing practices temporarily during core hours is acceptable – as sometimes there will be no alternative. 

"Initiatives to encourage experienced, highly-trained GPs to remain in practice is something the College has been calling for, so that this is enshrined in the contract is good news. 

"Frontline GPs will also be pleased that many of the more bureaucratic elements of our work have been taken into account and that we will get full reimbursement of CQC registration costs, as well as support for GPs to meet the rising costs of indemnity. 

"The College has been outspoken about the role of GP teams in charging overseas patients for care – but we have also said that where appropriate the NHS should be able to claim back money from the countries of those patients who use NHS services. The plans to introduce self declaration by patients at the point of registration is a straightforward exercise that should not be a significant administrative burden for GP teams, and should not deter patients from accessing care when they need it. 

"All in all, the contract should be encouraging news for GPs and our patients, but the changes certainly aren't a cure for the intense pressures currently facing our profession. We need the pledges made in NHS England's GP Forward View – for £2.4bn extra a year for general practice and 5000 more GPs by 2020 – to be implemented in full as a matter of urgency, so that we can continue to provide the care our patients need in a way that is safe for both them, GPs and our teams."


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BBC Health Check on general practice - RCGP responds

On charging patients for missed GP appointments:

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "When patients don't turn up for booked appointments it can be incredibly frustrating, especially at a time when demand for appointments is so high and some patients are having to wait a month to see their GP.

"GP practices are doing a lot of work to avoid patients missing appointments, such as sending email and text message reminders, with positive effects – and we would urge all of our patients, if they can't make an appointment, to let us know as soon as possible so that we can offer it to someone else.

"But charging patients when they miss appointments would involve significant overhaul of the administrative systems involved in general practice for very little monetary return as many people using services would be exempt from the charges. If a modest sum was charged, it would not be cost effective to set up – and if a more realistic figure was applied, it would disproportionately affect patients who are already struggling.

"In terms of introducing a charge to be able to see a GP within 24 hours – this would create a two-tier system of privatised general practice whereby those patients who can afford it get the care they need, when they need it, whilst those who can't are pushed to the back of the queue to wait longer.

"This would not help with the shortage of clinical staff and would fundamentally change one of the founding principles of the NHS, that care is free at the point of need, and is not something that the RCGP would support."

On GP-patient consultation times:

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "We have an ageing population in the UK, which is a great success of our society as a whole, but as our patients grow older many are inevitably living with more than one long-term condition, making the standard GP-patient consultation increasingly inadequate.

"GPs want to spend more time with our patients. We want the time to talk through all the different things that might be making a patient ill, and come up with a solid treatment plan in the best interests of their long term health – that's what GPs do. But with so many patients living with multiple conditions, affecting both physical and mental health, this simply isn't possible in 10 minutes.

"If we were able to offer longer patient consultations as standard, the current pressures facing general practice would make this incredibly difficult to fit in. Demand for our services has risen exponentially over the last few years, with recent research showing a 15% rise in patient consultations since 2010, but the number of GPs has not risen in step. Longer consultation times for some would mean fewer consultations on offer overall.

"In England, the GP Forward View offers a lifeline for our profession with promises of £2.4bn more a year for general practice and 5,000 more GPs by 2020. These pledges need to be implemented as a matter of urgency, and we need to see similar promises in Scotland, Wales and Northern Ireland.

"But as it stands in England, there are two Sustainability and Transformation Plans that actually propose reducing the GP workforce, there are five that don't mention the GP Forward View at all – and there are many others where the plans for general practice are vague at best. This is against all common sense – the future of our health service relies on high quality, robust general practice to underpin the rest of the NHS and provide care efficiently in the community.

"We need more GPs, more practice staff and more resources for general practice right across the UK so that we can offer our patients more appointments, and longer appointments to those who need them."


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