Last reviewed 24 September 2013

Health Secretary Jeremy Hunt has confirmed that he intends to change the GP contract to include a responsibility for practices to have a “named GP” to co-ordinate out-of-hospital care for vulnerable older people from 2014.

The changes will introduce an around-the-clock service that actively looks out for vulnerable patients, and will see GPs overseeing the primary care, social care, and accident and emergency (A&E) use of all vulnerable older patients on their lists.

Mr Hunt said many older people were using A&E simply because of the length of time they had to wait to see a GP, the difficulty in getting an out-of-hours appointment and not being able to get the care and support they needed from anywhere else. He claimed: “These changes will reduce the need for repeated trips to A&E, and speed up diagnosis, treatment and discharge home again, when patients do need to go to hospital.”

He went further, writing in the Daily Telegraph, to say that cover was so poor for older patients that in some cases A&E staff knew patients better than their own GPs did.

The DH’s proposals will be for a named clinician, probably a GP, to be responsible for the co-ordination of care for this group across the NHS, including in hospital, residential care homes and people’s own homes so that the care provided by the social care services and the NHS are completely joined up.

A £3.8 billion integrated care fund has been announced recently to help achieve this. The other area the Department of Health (DH) is working on is to make sure that information and patient records can be shared safely and securely across NHS and social care services to support a better integration of services and allow staff to spend more time providing care.

The British Medical Association’s General Practitioners’ Committee chair Dr Chaand Nagpaul said GPs were ideally placed to help address the challenges that the NHS is facing from an ageing society, but added: “Ministers have already acknowledged that GPs are working harder than ever before, but the Government must also realise that GP services are stretched to breaking point. GPs need increased time, space and capacity to care for vulnerable older patients. It is only through real investment, support and partnership with healthcare professionals that the NHS will be able to deliver the personalised, high-quality care for older people that we all want to see.”

Shadow Health Secretary Andy Burnham argued that the problems faced by A&E departments were not caused by the 2004 GP contract. He said: “In Jeremy Hunt’s first year in office, nearly one million people waited more than four hours in A&E. Ministers have left it too late and until they face up to the fundamental causes — the collapse of social care and front-line job losses — the NHS will continue to struggle.”