Health: Shake-up on way for GP out-of-hours service

A MAJOR shake-up of out-of-hours and urgent care NHS services is set to be carried out by the Government.

Tory Health Secretary Andrew Lansley, who made his first official NHS visit since his appointment at Leeds General Infirmary yesterday, said he wanted family doctors to take over responsibility for organising out-of-hours GP care.

The move would be part of a wider shake-up of other urgent care services including measures to reduce numbers of people unnecessarily visiting A&E.

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Out-of-hours care has long been the subject of controversy amid concerns about the numbers, quality and availability of staff at night-time and weekends as well as a series of high-profile failures in care leading to fatalities.

The Conservatives plan to give GPs a greater role including overall responsibility for commissioning services except those for maternity and specialist care.

Mr Lansley yesterday said family doctors could choose how this was done. They could decide what services were needed locally themselves, get primary care trusts (PCTs) to do it or even commission local authorities or private businesses to decide what services hospitals and community care sectors should provide.

GP leaders have shown little interest in taking over commissioning of NHS services – a role currently carried out by NHS managers working for PCTs – as most would prefer to concentrate on treating patients and do not want to be blamed for cutting services.

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The Government has pledged increases in NHS spending of 2.5 per cent each year although it remains to be seen if this is deliverable given the need to cut public spending and even then it is unlikely to be enough to cover increasing costs of NHS services.

NHS chief executive Sir David Nicholson, who accompanied Mr Lansley on his visit to Leeds yesterday which included the Department of Health's headquarters at Quarry House, has demanded efficiency savings of up to 20bn in coming years.

Mr Lansley acknowledged the "enormous anxiety" among the public about the quality of out-of-hours services, and said he did not want to turn the clock back so GPs were individually forced to handle overnight and weekend care of their patients.

Instead he wants to give them responsibility for commissioning urgent care services they felt were needed in their area. This would include the introduction of a new 111 number for people requiring urgent care.

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He claimed problems were not caused by lack of money, as the cost of services had more than doubled in the last six years, but in the way they were organised and integrated with other services and who was responsible for them.

He said the previous Government had directed services from the centre which had led to a lot of duplication. "I want to get rid of the duplication and give patients good quality access whenever they need to use urgent services," he said.