Out of hours services are not facing a crisis, minister says
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《英国医生杂志》
Changes to out of hours services should not cause a mass exodus of GPs from out of hours work. Nor should it effect emergency departments or care by GPs in normal hours, health minister John Hutton told MPs last week.
Mr Hutton was being questioned by the House of Commons Health Committee in the second session of its inquiry into GPs?out of hours services. Previous witnesses had expressed fears over the "potential crisis" in out of hours services when responsibility is transferred to primary care trusts (BMJ 2004;329:13).
Responding to the possibility of a large number of GPs choosing not to do any out of hours work, Mr Hutton said, "There is no evidence for this. In the trusts that have already converted the majority of GPs are still doing this work—and at least they are being properly rewarded for it."
The minister said, "This is not the end of out of hours care. We hope that patients will not notice any difference."
Mr Martin Shalley, president of the British Association for Emergency Medicine, previously expressed "grave concerns" to the committee about the potential impact that the new GP out of hours services could have on emergency departments.
Mr Hutton responded, "We are very alert to the risk of a potential negative impact on emergency department attendance; this is something we want to avoid.
"But these fears are ungrounded. We have figures that suggest the opposite. NHS Direct has become an excellent signposting service, resulting in an increase in appropriate versus inappropriate attendances."
Margaret Edwards, director of access at the NHS抯 Health and Social Care Delivery Group, who was also giving evidence to the committee, said: "Patient education is paramount. We need to tell people that arrangements are continuing and to communicate what is an appropriate use of the service—hence the 慤se the right service?campaign."
The committee questioned the minister about the implications of achieving the correct skills mix for out of hours services and about how the mix may effect NHS staffing in other areas.
"To begin with, GPs, along with some nurses, will be the mainstay of out of hours services. Skill mix is something that will evolve and will take time. It is a matter of years not months. We definitely do not want to denude other areas of NHS staff," he answered.
Mr Hutton insisted that the new arrangements would not affect community hospitals, a fear expressed by the BMA. He said, "This work is contracted separately outside of the GP contract. There is no link."
The inquiry came shortly after the health ombudsman criticised current out of hours care by GPs. In her latest report Ann Abrahams strongly criticised the quality of care, communication with patients, and record keeping in some GP deputising services.(BMJ Karen Hebert)
Mr Hutton was being questioned by the House of Commons Health Committee in the second session of its inquiry into GPs?out of hours services. Previous witnesses had expressed fears over the "potential crisis" in out of hours services when responsibility is transferred to primary care trusts (BMJ 2004;329:13).
Responding to the possibility of a large number of GPs choosing not to do any out of hours work, Mr Hutton said, "There is no evidence for this. In the trusts that have already converted the majority of GPs are still doing this work—and at least they are being properly rewarded for it."
The minister said, "This is not the end of out of hours care. We hope that patients will not notice any difference."
Mr Martin Shalley, president of the British Association for Emergency Medicine, previously expressed "grave concerns" to the committee about the potential impact that the new GP out of hours services could have on emergency departments.
Mr Hutton responded, "We are very alert to the risk of a potential negative impact on emergency department attendance; this is something we want to avoid.
"But these fears are ungrounded. We have figures that suggest the opposite. NHS Direct has become an excellent signposting service, resulting in an increase in appropriate versus inappropriate attendances."
Margaret Edwards, director of access at the NHS抯 Health and Social Care Delivery Group, who was also giving evidence to the committee, said: "Patient education is paramount. We need to tell people that arrangements are continuing and to communicate what is an appropriate use of the service—hence the 慤se the right service?campaign."
The committee questioned the minister about the implications of achieving the correct skills mix for out of hours services and about how the mix may effect NHS staffing in other areas.
"To begin with, GPs, along with some nurses, will be the mainstay of out of hours services. Skill mix is something that will evolve and will take time. It is a matter of years not months. We definitely do not want to denude other areas of NHS staff," he answered.
Mr Hutton insisted that the new arrangements would not affect community hospitals, a fear expressed by the BMA. He said, "This work is contracted separately outside of the GP contract. There is no link."
The inquiry came shortly after the health ombudsman criticised current out of hours care by GPs. In her latest report Ann Abrahams strongly criticised the quality of care, communication with patients, and record keeping in some GP deputising services.(BMJ Karen Hebert)