Emergency cash for out-of-hours GPs as demand for service soars

HEALTH chiefs have pumped another emergency cash injection into GP out-of-hours services for millions of people in the region.

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Patient demand was more than 50 per cent higher than expected for the West Yorkshire Urgent Care service in its first year in 2013-14.

Only 53 per cent of emergency cases were seen within a target of one hour, well below the expected 95 per cent standard, while fewer than three-quarters of urgent cases were seen within a two-hour target.

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NHS bosses poured an extra £2m into the service last year to support it meeting quality and safety targets and now a similar amount has been handed over on top of its £12.9m budget.

The service, which also covers Craven in North Yorkshire, dealt with 240,000 cases in 2013-14 against 157,000 cases estimated - 53 per cent more than expected.

Officials have put in place a number of measures to try to reduce pressures following a controversial national shake-up to create the NHS 111 helpline which refers patients to the GP out-of-hours service if required.

A project team is now reviewing the out-of-hours service to ensure it has the flexibility to manage increased demand or if patients’ needs could be better met elsewhere.

One key problem is that under the system, which is based on a national model, callers are no longer assessed by GPs before being referred for out-of-hours care. Under a new pilot in the region, family doctors will take a greater role at NHS 111 which has itself received another £300,000 to take its budget to £11.8m.

Carol McKenna, chief officer of NHS Greater Huddersfield Clinical Commissioning Group, said estimates for likely demand for out-of-hours services were based on good evidence but demand had been higher than anticipated.

“We are managing this locally through a service redesign project working closely with the providers to understand when and where the demand is highest and where possible, find appropriate ways to refer patients to better alternative services to get the help they need,” she said.

A detailed action plan had been drawn up to tackle problems with additional staffing at Local Care Direct, the Huddersfield-based social enterprise which runs the service.

GPs were being put in place at NHS 111 to reduce referrals to out-of-hours care, while other measures would lift pressure by referring callers to more appropriate care by mental health teams and district nurses. Plans being piloted in Kirklees from July could allow patients needing repeat prescriptions out of hours to go directly to a pharmacy.

She said patient feedback suggested the NHS 111 service was highly rated by the public.

Of 30 key indicators, the urgent care service was hitting all but two on access for emergency and urgent cases.

Meanwhile rising demand has led to spending on private ambulances in Yorkshire soaring by 267 per cent in less than three years.

Yorkshire Ambulance Service paid private firms £2.8m in nine months out of the 12 in 2013 – up from £782,000 from April 2011/12.

The number of incidents non-NHS ambulances were sent to annually rocketed by more than 1,000 per cent between 2010 and 2014.

Nearly 20,000 calls in total were responded to by private firms over that time.