GPs urged to reclaim continuity of care

GPs need to take back responsibility for round-the-clock care, the NHS Alliance has concluded in its report into the health service.

The report says the continuity of care general practice work provides is often critical, especially for people with complex and long-term conditions and the elderly.

The alliance, a collaboration of clinicians, managers and board members, argues that GPs do not need to provide all the care themselves but should be responsible for services and to join up care to make sure patients do not fall into gaps.

Its report, In Sickness and in Health, says GPs taking responsibility for 24-hour care would help patients to know where to go for care at different times of the day.

NHS Alliance chairman and GP Dr Michael Dixon said: "When the GP contract was negotiated, we didn't have practice-based commissioning or any other mechanism that would allow GP practices to commission out of hours and urgent care.

"Now that we do have the means, we should grasp the opportunity. Many doctors are concerned that healthcare is becoming more fragmented - highlighted by a recent survey that found one in five GPs would be willing to return to working out of hours."

He added: "The decisions about who should provide what services need to made locally, as close to the patient as possible, by GP practice-based commissioners supported by their primary care trusts and patient groups. And these are the people who should monitor the service as well.

"We have to build care around the patient, instead of expecting the patient to navigate a system that is convenient to the service."

The NHS Alliance report also calls for a new type of doctor: a community specialist
consultant, equivalent to a hospital consultant but with special training in the clinical and management skills needed to work across the boundaries between hospitals and primary care.

Responding to the report, health minister Lord Ara Darzi said: "I share the prime Minister's view that primary care is the lynchpin of a 21st century NHS and welcome this important contribution to the debate on its future.

"The next stage review will aim to build on the strengths in primary care, deepening the focus on health promotion, delivering more personalised, accessible and integrated services and rewarding high quality care - objectives which the NHS Alliance clearly shares.

"I look forward to ongoing collaboration, with the NHS Alliance and primary care professionals, to help us achieve our shared vision."