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Hunt: GPs must improve elderly care

New GP contracts are being drawn up that demand improvements in the way older patients are treated, Jeremy Hunt has revealed.

The Health Secretary said he had "no problem paying GPs well" if they were providing good care for the people they looked after but expects some doctors will be found to provide "inadequate" care.

In an interview with the Daily Telegraph he called on GPs to "rediscover family doctoring" but also said it was time for them to modernise by using emails to carry out some consultations with patients.

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

"I have no problem paying GPs well if they are delivering the kind of service we need particularly for older people."

Plans are being drawn up that will encourage surgeries to open from 8am until 8pm and they will be kept in check by a Chief Inspector of General Practice, who assesses practices and grades them.

"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.

"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."

Professor Steve Field, who has been appointed the new primary care policeman, said GP surgeries that offer inadequate care, do not open long enough or pose a safety risk to patients, faced being closed down.

Due to start in his new job on Tuesday, Prof Field told the Guardian: "I will not hesitate at all to order the closure of GP practices that we find to be unsafe, or providing poor access, or which do not care for patients properly or treat them with dignity."

The former chairman of the Royal College of GPs (RCGP) is the first chief inspector of primary care, a role created by NHS watchdog the Care Quality Commission to deliver greater scrutiny to NHS providers in the wake of the Mid Staffs hospital scandal.

Prof Field will oversee Ofsted-style ratings for GP practices and said he wanted access to GPs to be "brilliant" rather than merely "patchy".

"I think we should move to seven-day services in general practice, where patients should be able to access a GP for advice at the weekend," he said.

Dr Chaand Nagpaul, chairman of the BMA general practitioners committee, said: "The overwhelming majority of GP practices offer excellent care and have high patient satisfaction ratings. Intense workload pressures, due to the escalating demands of an ageing population and care moving out of hospitals mean GPs are seeing more patients than ever before - 340m in the last year. There are not enough GPs to cope with current demand, and in order to provide more services and longer access, there needs to be a massive expansion of GP numbers, staff and premises.

"There are a number of reasons why a small minority of GP surgeries are failing to provide adequate care, including in some cases working with inadequate resources and premises. Rather than beginning with a stick approach of threatening to close GP surgeries, with loss of local services to patients, we should adopt a systematic approach of enabling improvement in the first instance.

"The quality of out of hours care cannot be divorced from the serious failings and shortcomings of NHS 111 as the first point of contact for many patients. This must be addressed as a priority, as well as supporting an integrated approach for all providers of urgent care out of hours, which should include walk in centres, minor injury units, ambulance services, A&E and social care."


From Belfast Telegraph