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Out-of-hours GPs in hospitals urged

Out-of-hours GP services should be available in hospitals alongside emergency departments to try to stem the “overwhelming” number of patients seeking urgent care, leading doctors have said.

Patients should not be expected to be able to determine whether or not they are suffering a serious problem or minor illness and should have access to both levels of care, the group of senior doctors said.

But at the same time it is not appropriate for A&E departments to be responsible for “anything and everything”, they said.

New recommendations from the College of Emergency Medicine, the Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons, state that every emergency department should have a co-located primary care out-of-hours facility.

As well as out-of-hours family doctors, there should also be other health and social care workers physically located in emergency departments to bridge the gap between GP, hospital and social care services in order to support vulnerable patients.

They also said that community care and social care should be available seven days a week to support urgent and emergency care services, which would mean patients could be safely discharged outside of normal working hours.

The colleges set out 13 recommendations to address the challenges facing urgent and emergency care services across the UK and Ireland.

“Currently the challenges faced by urgent and emergency services overwhelm the capacity of the system. In consequence the delivery of quality care is compromised,” their report states.

Dr Clifford Mann, president of the College of Emergency Medicine, said: “The College of Emergency Medicine has been pressing for action to tackle the challenges facing the acute and emergency care system. If we are to avoid an annual crisis and build a resilient system it is vital that the 13 recommendations within this unique document are implemented.”

Dr Stephanie Smith of the Royal College of Paediatrics and Child Health said: “Emergency departments are being put under increased pressure as staff are faced with growing numbers of patients who are either unable to access out of hours care or who see emergency departments as the ‘go-to’ for all health complaints.

“What we need to do now, and as today’s report highlights, is have better access to out of hours primary care, provide doctors with appropriate training and access to advice from paediatricians, and have more effective and consistent advice and information sharing between healthcare professionals to reduce unnecessary admissions.”

Royal College of Physicians president Sir Richard Thompson said: “Over the past few years, services for ill patients have been stretched by the sheer amount of acute and emergency admissions, and we have to plan better for the future to protect patient safety. These 13 recommendations are practical, evidence-based, and produced by doctors who care for patients daily – if we do not implement them, we shall simply walk blindfold into another winter crisis.”

Clare Marx, president of the Royal College of Surgeons, added: “Particularly important, is the need for community and social care services to be co-ordinated and delivered across seven days a week to support our emergency care system.”

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