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Wider Role for Family Doctors Will Keep NHS in Good Health

Armen Hareyan's picture

Top doctor argues GP reforms will deliver faster, better NHS

A leading expert on GP services published a major report emphasising that the best way to improve patient care, increase efficiency and improve value for money is to adopt Government reforms moving more care closer to patients' homes into GPs' surgeries, health centres and community hospitals.

In a series of recommendations to Health Secretary Patricia Hewitt, the Government's GP 'tsar', Dr David Colin-Thome, today makes the clinical case for widening the role of family doctors to include services traditionally only found in hospitals.

Dr Colin-Thome advises that family doctors with accredited specialist skills should handle more minor operations. His report recommends that it becomes routine for specially trained GPs and senior consultants to work together in cottage hospitals and health centres.

He argues NHS patients would benefit from a one-stop service, where GPs could refer patients to consultants who are literally down the corridor. Operations like cataracts, hernia and varicose veins could be done on the same site, reducing waiting times and saving money.

The report also suggests GPs should take responsibility for the traditional six-week post-surgery check-up from hospital consultants. Some hospitals work in this way, why not all? Dr Colin-Thome believes that this approach would free-up consultants' time to see patients with more serious conditions, and if applied also to other routine check ups could deliver huge savings for the NHS every year..

National Clinical Director for Primary Care, Dr David Colin-Thome, said:

"Patients trust GPs. We're highly trained, offer high quality cost-effective services and our communities respect us, so why aren't we doing even more?

"Our training allows us to spot the first signs of cancer, give advice on weight loss and deal with depression and desperation. Many of us specialise in particular aspects of medicine and the nurses, midwives and pharmacists we work with have similar skills which the public value.

"Expanding the services GPs, nurses, midwives, pharmacists and other key staff such as physiotherapists provide in our communities and homes makes sense. And economically, it makes sense.

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"The evolution of GP services is about adding and improving, not cutting and rationing services. It is designed to take the pressure off hospitals and recognises that 21st century hospitals should be centres of excellence, but only for care that has to be delivered there - emergency and core specialist services. It allows us to give patients what they want - personal care closer to home."

Health Secretary Patricia Hewitt added:

"We know from the citizens summits ahead of our community White Paper that patients want more services closer to their homes. Services on their doorstep are more convenient, keep people out of hospital and are a more efficient use of NHS resources.

"I'm grateful to David for his report. It shows that to become a truly patient-led, modern health service, the NHS must transform itself further. Primary care - as the most frequently used part of the NHS - is perfectly placed to deliver those changes."

Other recommendations in the report include:

  • GPs must manage far more of patients' social and health needs

  • More consultants should work in health centres and community hospitals offering convenient ops

  • GPs, nurses and consultants can come together to form 'day surgery companies'

  • More GPs could work from one-stop health centres, so patients can get follow-up treatment and tests in a single visit

  • Pharmacists should take on a wider role and become even more of an invaluable point of contact for patients

  • A voluntary GP accreditation scheme would reassure patients that their GP is meeting clinical standards

The report stresses that patients will receive more personal care, delivered closer to home, if the NHS can offer a team of professionals, including GPs, nurses, pharmacists, physiotherapists and consultants, in response to an individual patient's needs.

GPs and their practices would have greater involvement in the care and treatment of their patients, as they would buy and design new services traditionally delivered in hospitals.