Health Secretary Jeremy Hunt has started to outline plans to improve the care of vulnerable elderly patients and ease some of the pressure on critically over-stretched A&E services, including where emergency funding of some £500 million over the next two years will end up.
The overarching aim of the government’s self-styled “radical changes” is to secure better integration across the general practice, social care and A&E factions, with patients to be overseen by a named clinician leading them through the entire system, in all likelihood a GP.
These changes will reduce the need for repeated A&E visits, as well as speed up diagnosis, treatment and discharge home again, when patients do need to go to hospital, according to Hunt.
The number of people going to A&E departments in England has risen by one million each year since 2010. And whether intentional or not, GPs certainly seem to picking up a lot of flack over the current emergency care crisis.
In an article published by The Telegraph, Hunt blames the Labour government’s changes to the GP contract – which allowed them to opt out of providing out of hours services – for creating a situation in which it is easier to visit A&E than get to see a GP.
“In fact, we’ve got to a point where A&E staff know some patients better than their own GPs”, he said. But the growing burden on A&E departments is unsustainable, and even with a two-year emergency cash pot ministers have warned of tough times over the winter period.
Emergency funds distribution
Of the £250 million available this year for those trusts in most danger, £62 million is for additional capacity in hospitals, to pay for extra consultant A&E cover over the weekends, for example. Around £51 million is destined for improving the urgent care services, and £25 million will go to primary care services.
But, Clare Gerada, chair of the Royal College of General Practitioners, says this investment is not enough. “Only 10% of the £25 0million is going to primary care, with no indication that any of it will be going to general practice”, she stressed.
“This is another missed opportunity to invest more money into mainstream general practice, enabling us to provide more services in the community so that patients, not least the old and vulnerable, do not go to hospital apart from when it is absolutely necessary”, Gerada argues.
In an emailed statement to PharmaTimes World News, a spokesperson for Age UK agreed that “GPs have a huge role to play”, but also stressed the need for “new local approaches that bring together all kinds of support services across Health and Care for older people, with voluntary organisations like Age UK playing a full part too”.
Themes for care plan
Looking forward, for the first time, any NHS Trust eligible for a share of the £250 million A&E funding for next year will need to ensure that at least 75% of its own staff have been vaccinated against ‘flu this year to help better protect themselves and vulnerable patients.
And the health secretary also announced three themes that will form the basis of a specific plan to improve care for older patients with complex health needs: the named clinician to champion a patient’s care across the system; joined up health and social care services; and information sharing to allow everyone involved in a patient’s care access to accurate clinical information at all times.
On this last point, by the end of 2014, at least one-third of A&Es should be able to see the GP records of their patients, and at least one-third of NHS111 services to be able to see the GP records of their callers, Hunt said.
