‘Flawed’ Government Plans On Urgent Care Overlook GPs, BMA Warns

Reforms to urgent care services are overlooking GPs in favour of non-medically qualified staff, the BMA says. Urgent care is defined as the range of services for people with problems which require urgent attention, but which are generally not-life threatening.

It includes out of hours services and walk-in centres. The BMA response to the ‘Direction of Travel of Urgent Care’ consultation from the English Department of Health says such services are increasingly based on non-medically qualified staff while GPs are disregarded. It warns that efforts to remove urgent care from general practice will lead to GPs losing their traditional ‘gatekeeper’ role and becoming de-skilled.

Dr Peter Holden of the BMA’s GPs Committee says: “Although many GPs are no longer responsible for out of hours care, up to half are still putting in shifts at evenings and weekends. However, despite the availability of GPs, it’s becoming increasingly common for Primary Care Trusts to design out of hours services around non-medically qualified staff. On some occasions this is inappropriate, especially when it’s done purely to save money.”

The BMA says the government consultation is “fundamentally flawed” because it fails to look at urgent care in the context of wider reforms in the NHS. It says that services need to be more clearly integrated, and that patients need better information about how to access them out of hours. The response emphasises the importance of GPs as co-ordinators of urgent care and expresses concern at their lack of involvement in some areas.

Dr Holden adds: “Unless the government sets out its proposals in context, and engages the public in a debate, it is impossible to have a genuinely open consultation. The involvement of GPs is crucial to the success of reforms to urgent care. It is disappointing that this consultation fails to acknowledge our core role. It would be wholly unacceptable to both doctors and patients if urgent care was removed from general practice.”

The BMA response calls on the government to set out more developed models of how urgent care might be shaped, for example GPs working in Accident and Emergency departments.

Dr Jonathan Fielden, chairman of the BMA’s Consultants Committee, says: “This document shows a clear lack of understanding of urgent care and the current impact of reforms in this area. The government needs to listen to the professionals rather than policy apparatchiks if they want to develop coherent change.”