Tag Archives: GPs

GPs who fail to spot cancer could be named

GPs with a poor record in spotting signs of cancer could be publicly named under new government plans.

Health Secretary Jeremy Hunt wants to expose doctors whose failure to spot cancer may delay sending patients for potentially life-saving scans.

Labour called the idea “desperate” and accused Mr Hunt of attacking doctors.

The Royal College of GPs said it would be a “crude” system and one that could lead to GPs sending people to specialists indiscriminately.

It warned this could result in flooding hospitals with healthy people.

The move is part of the health secretary’s plans to make the NHS more transparent.

Ranking GP surgeries on how quickly they spot cases of cancer and refer patients for treatment is among proposals being considered.

The information could eventually be published on the NHS website.

This follows a survey for the NHS last year, which suggested that more than a quarter of people eventually diagnosed with cancer had seen their GP at least three times before being sent to a specialist.

“We need to do much better,” the health secretary told the Mail on Sunday.

“Cancer diagnosis levels around the country vary significantly and we must do much more to improve both the level of diagnosis and to bring those GP practices with poor referral rates up to the standards of the best.”

Doctors found to be missing too many cases of cancer or with patients who are forced to make repeated visits before being referred for tests would be marked with a red flag.

A patient’s story

Susan has a sister with terminal cancer.

She told the BBC: “My sister was first told she had a prolapsed womb, then piles.

“By the time she was seen by an oncologist, eight months had elapsed.

“She has terminal squamous cell anal cancer – completely curable if caught early enough.

“She is 62, and now has a few months to live.

“One of the classic mistakes the GP made was to diagnose anal bleeding as piles. It wasn’t – it was the tumour.

“This doctor has condemned my sister to a year, so far, of terrible suffering and a death which is too dreadful to contemplate, when she could have been completely cured.

“Prognosis is something like 96% complete cure if treated early.”

Susan believes her sister’s GP should be “named and shamed” but thinks each case should be considered on an individual basis.

“As a retired teacher, I know what being continually maligned, judged, overlooked and overloaded can do to morale and performance,” she added.
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Those found with quick referral times for patients would be given a green rating.

Shadow health minister Jamie Reed said the government would not take responsibility for problems it had created in the NHS.

“David Cameron wasted billions on a re-organisation nobody wanted and left cancer patients waiting longer for tests and treatment. He should be ashamed of his own record – not attacking doctors,” he said.

“This government has thrown away progress made on cancer care. It is proof of why the Tories can’t be trusted with the NHS.”

‘Clog up clinics’

Dr Chaand Nagpaul, chair of the British Medical Association general practitioners committee, said to name and shame doctors would not help patients.

He said it was important to understand why there were delays in making referrals and to raise public awareness about the signs and symptoms of cancer.

“We need to look at the whole system and if you simply name and shame GPs, the tendency would be for us to refer everyone,” he told the BBC.

“And that can be a disadvantage because if we clog up hospital outpatient clinics, we’ll get patients who need to see their specialist actually having to wait longer.”

GP checking blood pressure

GP checking blood pressure Conservative MP Sarah Wollaston called for increased spending on the NHS

Conservative MP Sarah Wollaston, a former GP who chairs the Commons health select committee, said the government needed to be careful not to wrongly label people as “poor doctors”.

She too warned there was a danger of automatically referring everyone to a specialist and creating “impossibly long waiting lists”, which could harm those needing to be seen urgently.

Rising demand

Dr Wollaston added that she could not see how GPs could maintain current levels of service amid rising demand without a funding injection.

“The NHS budget has been protected in line with background inflation but that does not keep pace with inflation in health costs from rising demand and demographic changes,” she said.

“I don’t want to see any reduction in services. I would like to see further improvements and that will require an increase in funding.”

Dr Wollaston joined Conservative former health secretary Stephen Dorrell and Lib Dem former health minister Paul Burstow in calling for increased funding for the NHS.

Mr Burstow warned that the NHS was in danger of collapse within five years without extra spending. He said the health service needed an extra £15bn over that period in order to function properly.

Mr Dorrell said he would be ashamed if the government failed to increase NHS funding at a time when the economy was growing.

“I am in favour of the government not denying what 5,000 years of history tells us is true, which is that every time a society gets richer it spends a rising share of its income on looking after the sick and the vulnerable,” he told The Observer.

Source BBC News

Third of GPs back charging £10 to keep timewasters away from A&E units

The controversial proposal would be a “cost-effective” way to cut unnecessary A&E attendances and release pressure on stretched emergency departments, according to 32 per cent of a sample of more than 800 GPs in England.

To discourage patients attending A&E for minor ailments and injuries, the fees could be charged on arrival, but reimbursed if the patient was in genuine need of emergency care, the doctors said.

While acknowledging that charging at A&E was “a clear departure from the traditional NHS vision”, Dr Tim Ringrose, chief executive of the online forum Doctors.net.uk, said that many doctors were backing “radical action” to counter “the ‘free at the point of abuse culture’ that is a key contributor to the current emergency care crisis in some areas.”

However, the Royal College of General Practitioners (RCGP) said that the “vast majority” of doctors still believed that healthcare should be provided free at the point of need, and warned that credit card machines in emergency departments would be the beginning of “a slippery slope towards the Americanisation of healthcare”.

The survey, carried out by the Press Association, also revealed widespread scepticism about the Government’s plans to alleviate the A&E crisis by expanding the role of GPs.

Three-quarters of family doctors disagreed that giving elderly people a named GP responsible for their care would cut numbers attending A&E.

The plan is a key pillar of the new GP contract, hailed by the Health Secretary Jeremy Hunt as the return of “proper family doctors”.

Mr Hunt has previously blamed an increase in attendances at A&E wards since 2004 on changes to the GP contract introduced by Labour, which allowed family doctors to opt out of providing an out-of-hours care service.

GP leaders have furiously denied the claim, pointing out that pressures have increased across the system, with many family doctors seeing as many 60 patients in a single day.

A Department of Health spokesperson said there were “no plans to introduce fees” at A&E departments – as it would “go against the founding principles of the NHS”.

Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, said that pressures on the NHS would not be solved by “penalising less well-off patients by erecting financial barriers within the health service”.

“It could be counterproductive as patients who are deterred from seeking medical attention at A&E, may end up becoming more ill, requiring greater hospital care later on,” he said. “Patients could also inappropriately seek treatment at their GP practice, even if they genuinely need hospital care. This could act as a perverse incentive that sends patients in the wrong direction for their care.”

Dr Helen Stokes-Lampard, a GP in Lichfield and spokesperson for the RCGP, said: “Doctors have a duty to provide healthcare to patients regardless of their ability to pay. Patients seek healthcare when they are at their most vulnerable and if they attend A&E, it is usually because they don’t know where else to turn. Emergency departments are really struggling but the way to solve the crisis is to adequately fund general practice, so that family doctors can provide more care for patients…”

Attendances at A&E wards have increased from 18 million in 2004-05 to 22 million in 2012-13. There were a record 105,800 emergency hospital admissions in the first week of December 2013.

A&E wards missed a government target to see 95 per cent of patients in less than four hours for two weeks running at the beginning of December, with data for the Christmas period due next week.

Last winter, 6 per cent of patients waited longer than four hours in A&E departments – a nine-year high.

The College of Emergency Medicine has said the problems is rooted in a staffing  crisis, warning that the  country has a shortage of 375  emergency doctors.

Source The Independent

Patients will wait at least a week to see GP in 2014, it is claimed

Millions of patients will be forced to wait a week or longer to be seen by their GP surgery due to a shortage of family doctors, NHS figures reveal.

An estimated 27 million appointments will take place at least seven days after they are booked due to a shortfall of more than 8,300 GPs, according to the Royal College of General Practitioners (RCGP).

The number of GPs in England is falling while hospital doctor numbers swell, the college claimed.

It warned 71 per cent of family doctors believe waiting times will be longer within the next two years due to declining staff numbers and said this would increase pressure on already overstretched A&E units.

Dr Maureen Baker, chair of the RCGP, said: “If waiting times get longer, it will be more difficult for GPs to ensure that problems are caught early, and the pressure on A&E will intensify. This is bad news for patients and bad news for the whole of the NHS.”

She added: “It is vital to ensure that patients are able to access their local GP quickly and effectively – just as it is important for hospitals to have adequate numbers of qualified consultants to look after patients who are in need of acute health care.

“We need to ensure that we have enough GPs to provide patients with good access to high-quality health care in local communities across the UK.”

Last year 26.2 million people waited more than a week to see their GP, with a further 800,000 likely to face the same delay in 2014, according to the RCGP.

The RCGP published figures showing that three extra hospital consultant jobs are being created for every GP job.

Just 11 years ago there were 2,500 more full-time GPs than hospital doctors

Last year, there were 31,700 GPs compared to 38,200 hospital doctors, a difference of 6,500.

The RCGP expects the gap to widen further, with a predicted 37,000 GPs and 59,000 hospital doctors by 2022.

The falling proportion of GPs has coincided with a decline in the proportion of the NHS budget spent on general practice, the RCGP said, which has dropped to just 8.39 per cent despite GPs being responsible for 90 per cent of patient’s contact with the NHS.

The only way to cut down on the lengthy waits is to increase spending on general practice to 11 per cent by 2017, starting with an increase of one per cent of the NHS budget next year, it advised.

Dr Baker said: “Most people want to be looked after in their local community and they want to be able to see their GP quickly. The dramatic diversion of doctor posts away from general practice into hospitals works against this fundamentally important principle.

“Ministers say repeatedly that we need to alleviate pressure on hospitals by delivering more care in the community, yet the numbers of posts being created for consultants and GPs is completely at odds with this.”

Patricia Wilkie, chairwoman of the National Association for Patient Participation, said: “Patients greatly value being able to consult with and speak to their GP who is local, who knows the patient and their family and whom the patient trusts.

“Sadly very many patients are increasingly having to wait for one to two weeks and sometimes longer to see their GP.

“Unless there is an increase in the overall numbers of GPs and more financial resources to practices to employ more GPs to provide a safe and timely service, patients will have no alternative but to use A&E to receive the medical attention they need.”

Health Minister Dan Poulter said: “The recent GP survey showed that 86 per cent of patients rate their overall experience of their GP practice as good.

“To better support GPs, we have announced a £50 million fund for innovative GP practices to improve access for their patients so that working people and people who lead busy lives will have better access to GP services.

“Our new GP contract will also introduce more personalised care for vulnerable older people and same-day telephone consultations for the most vulnerable patients on practice lists.”

He said the Government had committed to increasing the number of GP trainees from 40 per cent of all newly-qualified doctors leaving medical school to 50 per cent by 2020.

Labour blamed the waits on the government’s decision to scrap a target that guaranteed patients a GP appointment within 48 hours.

Source The Telegraph

GPs ‘turning us into a nation of pill poppers’

GPs are 46 times more likely to prescribe medication for depression and other mental illnesses instead of other medically proven alternatives such as exercise, research has found.

The reliance on prescription medication comes as the study, commissioned by the charity Nuffield Health, indicates that mental illness is on the rise.

A survey of 2,000 people showed that 44 per cent experienced symptoms of anxiety regularly — up by a third since the recession began five years ago. The research suggests that the number of people experiencing low mood, an early indicator of depression, has also increased, jumping from 31 per cent to 39 per cent.

The study found that only 1 per cent of those who visited their GP were told to exercise to alleviate low mood or anxiety, compared with 46 per cent who were prescribed anti-depressants.

Dr Davina Deniszczyc , the medical director of Nuffield Health, said the trend indicated a “ticking mental-health time bomb in the UK’’.

“The compelling evidence that physical activity can play an important role in both treating and alleviating early symptoms of mental ill health isn’t sufficiently filtering through to front-line and primary care services,” she said.

“Nuffield Health is calling for all GPs to treat mental health as they would any other condition that can benefit from treatment with exercise — like chronic heart disease, diabetes and obesity.”

The push for less reliance on anti-depressants is supported by those surveyed, with only 4 per cent saying they would prefer to be prescribed medication over exercise, if given the choice.

The study also showed 76 per cent of those surveyed thought exercise lifted their mood and 72 per cent were aware it was clinically proven to manage moderate anxiety or low mood.

Beth Murphy, the head of information at Mind, the mental health charity, said prescription drugs were often used because there were long waits for talking therapies.

“Mind has found that people who do regular exercise or take part in eco-therapy activities such as gardening can improve their mental well-being and reduce feelings of depression,’’ she said.

“We urge health professionals to take alternatives such as exercise seriously and consider a range of treatments that offer more choice for individuals.’’

Almost half (46 per cent) of those surveyed said financial worries were a key contributor to low mood; 43 per cent of respondents identified family issues, while 36 per cent said problems at work played a role. Only 8 per cent said ill health affected their mood.

It comes a week after a report by the Chartered Institute of Personnel and Development, in partnership with Simply Health, revealed that mental health problems and stress were rising among staff, as reduced workforces made heavier demands on their time.

The number of organisations reporting an increase in workers suffering from mental illness has doubled over three years to 42 per cent.

The report identified volume of work as the biggest cause of stress, followed by management style.

Source The Telegraph

GP care in England ‘faces funds catastrophe amid cuts’

The GP system in England is facing a “catastrophe” because of cuts in funding, doctors’ leaders are warning.

Analysis by the Royal College of GPs suggests that over the past three years, investment in general practice has fallen by £400m in real terms.

That is equivalent to a 7% cut in spending per patient, it says.

The government said it was providing new funding to help under-pressure GPs, but Labour said the figures showed ministers’ promises had not been kept.

As GPs gather in Harrogate for the royal college’s annual conference, its chairwoman Dr Clare Gerada said the cuts meant doctors were being required to do more work with fewer resources, damaging services for patients.

The warning comes in the week ministers said they wanted to extend GP surgeries’ opening hours.

On Tuesday, the prime minister said he wanted more patients to be able to get help in the evenings and at weekends, as he set out details of a £50m pilot programme in nine areas of England to widen access.

But the college said the analysis – based on official data from the Health and Social Care Information Centre – showed the government was taking money away from GPs despite claiming it wanted to move care away from hospitals.

‘Increasing workloads’

In 2012-13, £8.5bn was invested in general practice, when everything from spending on pay, IT, tests and drugs was taken into account, it said.

In many ways it is hard to measure what effect the cuts cited by the RCGP might be having.

The most obvious measure of judging performance used to be through the 48-hour target for waiting for an appointment. But this was scrapped by the coalition.

The Patients Association has consistently said the feedback it gets flags longer waits as an issue.

The RCGP also says it is getting harder to keep extra services going; such as dieticians and talking therapies.

Some of the biggest cuts have been among these ‘enhanced services’ – and in longer opening hours, the very thing ministers were talking about extending earlier this week.

For a government that makes a big play of protecting the NHS budget, it raises some tricky questions.

That compared with £8.3bn in 2009-10, which is the equivalent of £8.9bn in 2012-13 prices.

In terms of spending per patient, that represents a fall from £168.40 a year to £156.45 – a drop of 7%.

Dr Gerada also pointed out that the investment represented 9% of the entire NHS budget, even though GPs had 90% of the contacts with patients.

She said: “Our figures should send out a warning to government and the rest of the NHS that we will soon have a catastrophe on our hands if urgent action is not taken to reverse the decline in funding.

“GPs are keen to do more for their patients, but we are heaving under the pressure of ever-increasing workloads and diminishing resources.

“Some of us are routinely working 11-hour days with up to 60 patient contacts in a single day and this is not safe or sustainable.

“You do not want a tired GP seeing you. You do not want a tired GP any more than you want a tired pilot or a tired surgeon.”

‘Tipping point’

Dr Gerada also expressed concern about the season ahead and said general practice was close to reaching a “tipping point” which would see the profession “fall over”.

“We’re trying to squeeze more and more activity out of a smaller and smaller pot of money,” she added.

“If we have a cold winter, I’m really afraid that patients will suffer considerably.

“The front door of the NHS is the GP’s surgery. If that gives, the rest of the NHS will give and very rapidly.”

Health Secretary Jeremy Hunt is due to address the conference on Thursday afternoon.

Patients Association chief executive Katherine Murphy said: “This chimes with what patients are saying to us. They are finding it harder to access GPs both in and out of hours.

“The mantra is about moving care out of hospitals and into the community, but if we are going to achieve that we have to stop throwing money at hospitals and invest in GPs so they can provide quality care.”

‘Tsunami of work’

Dr John Crompton, a GP in Yorkshire for more than 20 years, believes doctors are struggling to cope with the demands of an ageing population.

He said: “People now don’t just have one condition, they have several conditions, and also obviously getting on to getting increasing memory problems and frailty in old age.

“We’re very frightened that there is a tsunami of work coming out, without the resources.”

Shadow health secretary Andy Burnham said: “These figures are embarrassing for a prime minister who got elected on a promise not to cut the NHS.

“They make a mockery of yet more promises he has made on GP access this week and show he simply can’t be trusted on the NHS.”

But a Department of Health spokeswoman said it knew GPs were “under pressure to do more with tight budgets”.

“That’s why this week we announced a £50m fund for GPs who want to pioneer new ways of working, to help make the best use of their time.”

Source BBC News

Cameron promises more flexible GP hours

David Cameron says he wants to offer more patients the chance to visit a GP in the evening or at weekends.

Under a scheme to be piloted in nine areas of England, surgeries will be able to bid for funding to open from 8am to 8pm seven days a week.

The prime minister said the £50m project would mean doctors “fit in with work and family life”.

Mr Cameron has also denied his plan for a budget surplus in the next Parliament will lead to further spending cuts.

The prime minister said the 2008 banking crisis had brought the UK economy “to the brink” and it would be irresponsible not to put money aside for a “rainy day” when the economy improved.

In other developments on the penultimate day of the Conservative Party’s annual conference in Manchester:

  • Mr Cameron said he would welcome MBoris Johnson back to Parliament while the Mayor of London has urged the Tories to go “flat out” for victory in 2015.
  • The proposed marriage tax break is “very much a first step” to recognising the institution in the tax system, Mr Cameron said
  • The prime minister said he “understood” Ed Miliband’s reaction to an article in the Daily Mail about his father and newspapers and politicians should show “judgement” about press limits
  • Work and Pensions Secretary Iain Duncan Smith outlined plans to force the jobless to attend 9-5 classes at job centres
  • Culture Secretary Maria Miller says a new £10m fund will be set up to mark UK historic events, such as forthcoming anniversaries of the Magna Carta and the Battle of Waterloo

Manchester is already piloting an extended-hours scheme for GPs, with family doctors grouping together to offer extra care, in what is being billed as an attempt to prevent “unnecessary” visits to hospital A&E wards.

‘Skype appointments’

The wider scheme will see practices applying for a share of a £50m “Challenge Fund”, with surgeries becoming “pioneers” in each of nine regions, starting in 2014/15.

The Labour government encouraged practices to open later in the evening and on weekends – offering them extra money if they did so.

Most GPs gave it a go. But the problem was that in many places there was just not the demand and so the funding was reduced and hours cut.

There are still plenty of surgeries that offer out-of-hours appointments, particularly in large urban areas.

But the truth is that the people who are most likely to make use of the service – those of working age – are the least likely to need a GP.

Whereas, the elderly and children who are the most frequent users tend not to have a problem attending appointments during regular hours.

Mr Cameron is also promising more “flexible access”, including email, Skype and telephone consultations for patients who prefer this to face-to-face contact.

He told the BBC: “Many hard working people find it difficult to take time off to get that GP appointment, so having these pilot schemes… is, I think, a very positive step forward.

“It also links to the problems we have seen in our accident and emergency departments because the number of people going to A&E departments is up by four million since the changes to the GP contract that Labour put in in 2004.

“What we need to do is enable the right people with the right ailments, as it were, to either go to a GP or to accident and emergency.”

’24/7 society’

Health Secretary Jeremy Hunt said: “We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people.”

Jeremy Hunt: “We need to rediscover the ideal of family doctors”

The Royal College of GPs said doctors were keen to do more, but were already struggling with their workload.

“We now need the government to go much further and give general practice its fair share of the NHS budget so that GPs can deliver more care and better access to services for their patients in the community,” it said.

But Labour said an extended opening scheme introduced by the last government had been scrapped.

“Under the Tories, hundreds of GP surgeries are shutting their doors earlier,” said its health spokesman Andy Burnham.

“Patients are also finding it harder to get appointments, and turning to A&E instead, after he removed Labour’s guarantee of an appointment within 48 hours.”

In his speech to conference, Mr Hunt also pledged to legislate to give the Care Quality Commission statutory independence from government.

This would end “political meddling” and ensure the interests of patients were always put first, he said.

‘No splurge’

The Conservatives say they would continue the coalition’s policy of fiscal restraint throughout the next parliament – if they form the next government – with the aim of achieving a budget surplus.

Mr Cameron said this would require tough decisions for the next six or seven years but did not “necessarily mean” there would have to be more cuts on top of those announced up to 2016.

“What it definitely means once those years are over you cannot sort of plan another spending splurge. We are going to have to be responsible in our country for very many, many years into the future.”

The government was right to focus on containing spending, he added.

“I don’t think you tax your way to a strong recovery and we need to recognise that hard working people need more money in their pockets to spend as they choose.”

The prime minister also insisted that the government would find the money to freeze fuel duty until 2015, describing help for motorists as a “real priority”.

Source BBC News

GPs must earn their pay by treating elderly better, says Health Secretary

GPs must improve their treatment of older patients and undergo new independent checks of their care if they are to keep their generous salaries, Jeremy Hunt has said.

The Health Secretary told The Telegraph that some doctors will be revealed as providing “inadequate” care in the same way that failing NHS hospitals have been exposed, adding that GPs must “rediscover family doctoring”.

Doctors will also be encouraged to consult their patients via email to save time and money.

Mr Hunt also disclosed plans for new independent scrutiny of NHS trusts, which will mean that more hospitals are found to be “failing”.

He is preparing to begin negotiations for a new contract of employment for GPs, who were paid an average of £103,000 last year.

The contract will make clear that GPs must take better care of older patients and ensure that fewer of them end up in hospital, he said.

“I have no problem paying GPs well if they are delivering the kind of service we need particularly for older people,” Mr Hunt said.

Having spent his first year as Health Secretary focusing on hospitals and scandals at Mid Staffs and Morecambe Bay, Mr Hunt said his “big challenge for next year” would be overhauling primary care provided by GPs.

He said there was a “pressing need” for a change in the way doctors deal with elderly patients, to make GPs monitor patients more closely and ensure that fewer of them end up in hospital.

Unnecessary admissions to accident and emergency units of patients who cannot see a GP are a major cause of pressure on the NHS.

“We need to change the model for reactive primary care to proactive primary care and that’s rediscovering the idea of family doctoring, and the idea of a GP who keeps tabs on people whether or not they’re ill,” he said. Ministers are working on plans to encourage GP surgeries to open from 8am until 8pm, and Mr Hunt said that doctors should change they way they deal with patients, including consulting them via email.

“We need to be much more ambitious about how people access the system in ways that cost the system a lot less,” he said.

“We’re trapped in a mentality where the heart of primary care provision is a 10-minute GP appointment when actually if you look at what happens in the US, they find that if you allow people to ask questions by email it is cheaper and quicker.”

As well as a new contract, GPs will face a new system of oversight, with a Chief Inspector of General Practice assessing practices and grading them. Inspections will uncover the sort of failures in general practice already revealed in hospitals, Mr Hunt said. “I think we’ll find probably what there is in hospitals, that there is considerable variation.”

A fund to pay for life-extending drugs for cancer patients will be extended for two more years, the Prime Minister has announced.

The Cancer Drugs Fund, worth £200 million a year, was set up for patients to access treatments which were sought by doctors but which have not been given the go-ahead for widespread use.

Several charities welcomed the news, but some said it was a “sticking plaster solution”.

Source The Telegraph

Millions of A&E patients ‘should just see their GP’ to avoid crippling emergency services

Millions of patients going for treatment in A&E should see their GP, a paramedic or chemist instead, says a senior NHS official.

Professor Keith Willett, who is leading a review of accident and emergency services, said up to 30 per cent of those who use casualty units would be better treated elsewhere.

But he admitted that 6.5million patients who needlessly queue at A&E are frustrated by long waits for a GP appointment or lack of access to out-of-hours care.
Choices: Patients should see their GP as oppose to clogging up A&E according to a senior NHS official

Choices: Patients should see their GP as oppose to clogging up A&E according to a senior NHS official

In an interview to be broadcast on Sky News today, Professor Willett says the NHS review will ‘start to address the demand’ by improving primary care, which he says clearly ‘did not make itself available’ to some patients.

England’s A&E departments were in crisis last winter. Waiting times were the worst for nine years, with more than 300,000 patients waiting four hours or more.
 
Professor Willett’s review, published this autumn, will state that all A&E units must always have a consultant available, and other senior doctors on duty, including elderly care specialists.

LANGUAGE TESTS FOR FOREIGN DOCTORS

Foreign doctors working in Britain will face language tests if concerns are raised about their fitness to practise.

It follows a string of scandals in which overseas doctors have been blamed for poor care.

Currently only those from  outside the European Union are given strict language tests, but from next year the doctors’ regulator, the General Medical Council, will test all applicants.

In addition, those who are already working can be tested if they are going through disciplinary proceedings.

Health minister Dr Dan Poulter said: ‘Overseas doctors make a hugely valuable contribution to the NHS but it is clear that tougher checks are needed.’

Paramedics will be sent to treat more patients at home or by the roadside so they do not need hospital care, and patients will be told to ring the 111 helpline to see what care is appropriate.

‘We have to manage the situation and take away from emergency teams those patients who could be managed by other parts of the system,’ he said.

‘We know that 15 to 30 per cent of people who turn up to be treated at A&E could have been treated in general practice. We can look at the way primary care is available to people, by changing the way we deliver services.’

He asked the public to ‘understand the issues’ and consider calling for advice or contacting a GP or pharmacist.

But Dr Chaand Nagpaul, chairman of the British Medical Association’s GPs committee, said family surgeries are ‘bursting at the seams’, and the 111 number is not fit for purpose.

‘There is no doubt there are patients who attend A&E who would be better treated in a community setting, but NHS 111 has been fuelling the problem by inappropriately advising patients to go to hospital,’ he said.

‘That needs to be improved so people get quality advice from clinicians, not untrained people using a computer program.’
The Government has given the NHS an extra £500million over two years to find short-term solutions to the likely rise in demand for emergency care in the winter.

Source The Mail Online

Half of family doctors believe they cannot guarantee safe care

One in two family doctors believes that they “can no longer guarantee safe care to their patients” as pressures on GP practices countrywide continues to mount.

In a poll conducted the Royal College of General Practitioners (RCGP), 85 per cent of GPs said that their profession was “in crisis”, while 93 per cent said that working in general practice had become more stressful in the past five years.

The 2004 GP contract, which saw family doctors opt out of much of the out-of-hours care they once provided, has been blamed for soaring waiting times in A&E units by the health secretary Jeremy Hunt. However, 84 per cent of GPs said that their own workload had increased “substantially”. The Royal College is now calling for 10,000 new GPs by 2022, and a 10 per cent leap in funding for general practice.

The RCGP’s chair Dr Clare Gerada called the findings of the poll, of 258 family doctors, “truly shocking”.

“The findings… explode the myth, peddled by certain people in recent weeks, that GPs are somehow working less hard than other professionals across the health service,” she said.

“General practice has radically altered over the last five years, with ballooning workloads, and more and more patient consultations having to be crammed into an ever expanding working day – as the patient population grows older and increasingly suffers from an increasing range of ailments.”

Nine of out ten contacts the public has with the NHS are through GPs, but general practice only receives nine per cent of NHS funding.

The Department of Health acknowledged that GP surgeries had become extremely busy, while Labour said that doctors’ surgeries were “paying the price of David Cameron’s broken NHS promises.”

Relations between Mr Hunt and the powerful GP lobby were severely soured by his assertion that the 2004 GP contract, which saw family doctors hand over responsibility for much out-of-hours care to agencies, urgent care units and A&Es, had been “disastrous”. Leading doctors called his attack “childish and superficial”.

However, Dr Gerada appeared to offer an olive branch last week when she suggested GPs could take back responsibility for the round-the-clock care of a small number of patients who disproportionately require A&E and out-of-hours care, including the frail and elderly and those with complex health problems and those who require mental health services.

More than half of GPs said that they already worked until at least 7pm, and saw between 40 and 60 patients every day. Forty-six per cent said they spend at least 11 hours a day in surgery.

“Patients are now struggling to get appointments and GPs are forced to juggle the needs of fifty patients per day,” said Andrew Gwynee, Labour’s shadow health minister. “Ministers must put in place a plan to stop the deterioration in primary care services. Patients are paying a high price and they deserve better.”

An NHS England spokesman said: “General practice makes an enormous contribution to people’s health and well-being. We also know that the majority of people rate their overall experience of their GP practice as good and they have confidence and trust in their GPs. However we recognise that the way primary care is delivered is changing and that a complex range of factors are causing pressures on GP services. We want to explore with the profession how we can best enable GP practices to continue to provide a quality service and we look forward to working with the RCGP to identify how best to achieve these goals.”

Source The Independent

Link between doctors and patients is broken, Jeremy Hunt says

The problems facing overstretched Accident and Emergency services are “scandalous”, the Health Secretary admitted, suggesting one way to save the NHS is to make family doctors take more responsibility.

His comments come after Dr Clare Gerada, chair of the Royal College of GPs, proposed that GPs take back 24 hour care of the neediest patients who put disproportionate strain on the NHS.

Mr Hunt has been locked in a bitter dispute with medical professionals over his proposals to save the health service, and an increasing number have warned him that the situation is out of control.

“It is scandalous, the number of people who are using emergency services when actually, if they had a better alternative, they wouldn’t,” he admitted on ITV’s Daybreak yesterday.

Mr Hunt said that one of the ways to solve this was make sure there are viable alternative, adding “at the moment it’s just too difficult to see a GP is you need to see a GP”.

When it was put to him that he had failed resolve the issues as the new 111 non-emergency number was plagued by problems, Mr Hunt said that that is “exactly” what he was sorting out.

He promised to review GPs contracts, which had the responsibility of out-of-hours care removed by Labour in 2004.

“That really is the heart of where the problems started because it removed that 24/7 responsibility for people on their lists and it made people feel distant from their GPs, and that is exactly what I have suggested we need to look at.

“It’s wrong at the moment that we have broken that personal link between GPs and people on their lists.”

He praised the work of family doctors, but said they had been given contracts which were more about “box-ticking” than people.

His proposals to review contracts have led to scathing attacks from medical professionals, who have said he is being unrealistic.

The comments of Dr Gerada are likely to cause more divisions.

She said that GPs should lead the way in helping those most in need and take on round the clock care for the 5 per cent of patients who require the most attention – roughly 3 million patients.

However, for the plans to work there would need to be another 10,000 GPs, the equivalent of roughly one per practice, she added.

Source The Telegraph