GPs failing elderly patients: Hunt
Tuesday 10th September 2013, 3:11AM BST.
A “much better way” is needed for “vulnerable old people to journey through the NHS”, Health Secretary Jeremy Hunt has said.
Family doctors are failing elderly patients and must start to take responsibility for them while they receive hospital treatment or move into care homes, he argued.
In an article for The Daily Telegraph, Mr Hunt said elderly patients needed someone to keep track of them and look out for them “all the time”.
He argues that it has become easier to go to A&E and harder to go and see a GP, resulting in some A&E staff knowing some patients better than their own GPs.
Mr Hunt has called for a change in the work of family doctors which will result in them being more responsible for the care and treatment of older patients.
“We need a much better way for vulnerable old people to journey through the NHS. They need someone from the service to be keeping tabs and championing them through the system all the time – and making sure they’re a name not a number, whether or not they are in hospital,” Mr Hunt writes.
“As a member of the public I would like that responsible person to be my GP.”
Mr Hunt says there is a “need to remove the cracks between the NHS and social care systems”, remarking that GPs can not champion patients through the system unless they work closely with care homes.
The article recalls a time when Mr Hunt saw an elderly woman with dementia taken into hospital from a care home.
“Confused and unable to speak after a fall, that A&E department was probably the worst place for her,” he said.
He went on to point out that staff did not know her medical history, her allergies and whether her lack of speech was normal or caused by the fall.
He added: “But her experience proved what many of us know in our gut – too many old people feel there’s no reliable alternative to hospital.”
Mr Hunt says the 2004 contract changes “undermined the personal link” between GPs and their patients, as well as “imposing a whole range of bureaucratic burdens”.
Mr Hunt was asked about a Daily Mail report that only five consultants were on duty in A&E departments in England overnight.
All but five NHS trusts employ an on-call consultant who can be contacted between midnight and 8am, rather than having someone actually working on site.
“Most A&Es have an on-call system at certain times of day,” Mr Hunt told the BBC Radio 4 Today programme.
“I agree that we need to beef that up.”
Mr Hunt said a portion of the £500 million winter funding would go to help pay for extended consultant cover.
“About a quarter of the £500 million that the Prime Minister announced is going towards increasing consultant cover,” he said.
“We need more consultant cover at the times A&Es are the busiest.
“Certainly about one quarter of that money will be going to that. But the broad point is that we need to attack this problem from lots of directions – better alternatives in primary care, more consultant cover in evenings and weekends when the pressure is greatest, better IT systems.”
Dr Clare Gerada, chair of the Royal College of General Practitioners, said: “The Health Secretary’s comments will be disheartening and morale-sapping for the thousands of hard-working GPs across the UK who are battling against the odds – with ever dwindling resources – to provide the best possible care to their older patients.
“No other part of the health service delivers the personalised care and continuity of care provided by general practice; care that is highly valued and trusted by our older patients. To accuse family doctors of neglecting these patients, both in the community and when they go into care homes or hospital, is untrue and unacceptable.
“The Health Secretary is right to make the care of vulnerable older people a priority. As the population in general ages, older patients are increasingly coming to GPs with complex, chronic and multiple conditions. They are consulting with GPs more regularly and GPs want to spend more time with them.
“But, because of insufficient resourcing for general practice, four out of five family doctors are concerned that it will become increasingly difficult to deliver continuity of care to vulnerable elderly people.
“GPs are doing 90% of the work in the NHS, for just 9% of the NHS budget. There are more than one million consultations in general practice every day and GPs are routinely working 11-hour days, sometimes making up to 60 patient contacts in the space of a single day.
“We want to do more for our patients but we simply do not have the capacity to take on any more work, without the extra funding and resources to back it up.
“Once again hard-working GPs are being attacked when the Government should be supporting them and giving general practice its fair share of NHS funding. Without that we cannot provide the quality of services in the community for all our patients that we all want.”
Shadow health secretary Andy Burnham has been granted an urgent question on the pressures on accident and emergency departments.
It is due to be heard in the House of Commons at 12.30pm.