Ever since GPs we allowed to contract out of Out of Hours (OOH) the service for patients has been worse. The knowledge of both medicine and the families who rang him, allowed GPs working in co-operatives to manage calls appropriately. This was the highlight of my career as a GP, and the teamwork involved was superb. Even continuity of care for the palliative and terminally ill was catered for by many GPs who gave their mobile phone number to the co-op doctor. The decision to stop our co-operative was taken by our trust. At the time, Trusts were not allowed GPs on the board , and they still don’t want to listen to GP opinions today. Cluster meetings imposed by the Welsh Government are attended simply to avoid financial loss…. GPs can revive the service only if they are given real power, both in implementation and in strategic planning in a rationed health service. When something appears to be free it is not valued. An insurance policy without an excess and a no claims bones is not viable – same as the UK Health Services.
Now Chris Smyth reports 30th June 2017 in the Times what GPs could have told the government straight away once Mr Blair released us from OOH: Millions of needless NHS 111 referrals to hospitals and GP surgeries
Millions of people are needlessly sent to hospitals and GP surgeries by the NHS 111 helpline, health chiefs have admitted for the first time.
Four in five referrals to GPs and A&E could be avoided if callers were able to speak to a doctor, NHS England says.
Matthew Swindells, director for operations, said most patients’ problems could be successfully dealt with by a phone consultation, sparing them the need to go to hospital or surgeries.
The 111 helpline for urgent but non-emergency problems sent a million people to A&E and seven million to family doctors in the past year.
Mr Swindells said: “If the patients were told by the guidelines that they should go to their GP, if they talk to the GP on the phone 80 per cent of them don’t need to go to the GP.” He said that for those told to go to A&E, 85 per cent did not need to go if they could speak to a doctor over the phone.
The helpline has been dogged by claims that it sends too many people to hospital because it relies on call handlers with no medical qualifications who follow a risk-averse algorithm.
NHS 111 sends out 20,000 more ambulances a month than its predecessor NHS Direct, which was staffed by nurses. NHS England has long insisted that 111 prevented people going to A&E, but in March it admitted the service needed more doctors and nurses.
Within a year it wants a third of callers to be able to speak to a doctor or nurse, up from 22 per cent now, “so that only patients who genuinely need to attend A&E or use the ambulance service are advised to do this”.
Mr Swindells told the Health+Care conference in London that the changes were “about enhancing 111 so that when you ring you don’t just get shifted somewhere else; you actually get a clinical consultation”. Research this year found that a quarter of people going to A&E with minor problems had called NHS 111 or an ambulance first but were not given proper help.
Mr Swindells says family doctors must “deliver the first contact of care that was necessary so that people don’t turn up at GP practices, so that people don’t turn up in A&E”, Pulse magazine reported.
Chaand Nagpaul, the head of the British Medical Association, said far too many patients were coming to surgeries for “inappropriate or bureaucratic purposes” such as sick notes.
He said one in four appointments were taken by people who could have waited to get better, seen a pharmacist or needed paperwork.
“Not wasting GP appointments is also key to addressing hospital pressures,” he said at the BMA conference in Bournemouth.