24.05.13
GPs should be accountable to patients – Hunt
The NHS should “return to the idea of the family doctor”, health secretary Jeremy Hunt has stated. In a speech to The King’s Fund, he described difficulties patients have in securing appointments for the same day, or the next day, and long waits on the phone, sometimes at premium rate numbers.
His speech escalated the row with GPs, who argue that they are under too much pressure to resume responsibility for out-of-hours care. Earlier, Dr Laurence Buckman, chairman of the BMA’s GP committee, had accused Hunt of “spouting rubbish”. Buckman warned that the causes behind increased pressure on A&E were complex and should not be blamed simply on GPs.
Hunt said: “We have allowed ourselves to lose sight of the concept of the family doctor – the sense that GPs are there to be a champion for their patients rather than simply a gateway to the system.
“Patients in hospitals are under the care of accountable clinicians. The consultant responsible doesn’t do everything him or herself. But if something goes wrong, you know where the buck stops. But when a vulnerable older patient needing follow-up and ongoing support leaves hospital, who is the accountable clinician? As a member of the public, I would like that to be my GP.”
Candace Imison, acting director of policy at The King's Fund, said: “Our independent inquiry into quality in general practice found widespread variations in the quality of care provided by GPs. This issue rarely gets the attention it deserves, so we welcome the emphasis the Secretary of State has placed on it this week.
“The appointment of a new Chief Inspector will give quality in general practice a higher profile and place it on the same footing as hospitals and social care. However, regulation and inspection can only provide a backstop – the main responsibility for quality of care lies with GPs and their practices. It will also be important to focus on other proven ways to drive quality improvement including peer review and making more performance data available to the public.
“GPs need to move from being gatekeepers to navigators, co-ordinating care for patients with complex needs and being held accountable for the quality of care they provide. So we welcome the commitment to ensuring that older patients are supported by accountable clinicians – this will help to deliver integrated care.
“The GP contract does need to change to reflect the way general practice needs to improve. However, it is not the only source of the problems highlighted by the Secretary of State and is not the main driver of pressures in emergency care – the reasons for this are much more complex.
“It is essential for general practice to embrace change to improve the quality of care for patients and meet the challenges of the future. The rhetoric from all sides must now be followed by constructive dialogue and concerted action to ensure this change is delivered.”
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