Budget 2017:Doctors oppose plan for GPs in struggling A&Es

Hospitals will be given up to £100million to install GPs in their struggling A&E units, the Chancellor announced.

Philip Hammond unveiled plans which will see family doctors treating the less seriously ill in up to 100 casualty departments.

But doctors’ leaders opposed the scheme and warned it would only attract more patients to A&E hoping to be seen quickly.

They also warned it would divert GPs away from understaffed surgeries.

The Government hopes the scheme will reduce pressure on A&E units which have just seen one of their busiest ever winters.

Some departments were so overcrowded that elderly patients were queuing on trolleys for up to 30 hours. Hospitals will be told to apply to the Department of Health for a share of the money, setting out details of how their scheme would work.

Many are expected to propose setting up a primary care centre alongside their A&E – staffed by GPs – to treat patients with minor ailments. They will operate a ‘triage’ system on the door of A&E where GPs or nurses will assess all patients upon arrival.

Those with coughs, colds or minor injuries will be sent to the primary care centre, freeing up casualty staff to treat the most serious cases. Such schemes already exist in some UK hospitals, including Homerton in East London. Many others employ one GP in A&E during busy periods.

Mr Hammond said inappropriate A&E attendances by patients of all ages was one of the big pressures on hospitals. ‘Experience has shown that onsite GP triage in A&E departments, can have a significant and positive impact on A&E waiting times.

‘I am therefore making a further £100million of capital available immediately for up to 100 new triage projects at English hospitals in time for next winter,’ he said. But Dr Mark Porter, council chairman of the British Medical Association which represents doctors, said: ‘Having GPs in A&E won’t reduce admissions – if anything, this could have the effect of attracting more patients.

‘The Government also needs to explain how it will fund and recruit GPs to work on site at hospitals when there already aren’t enough to meet the needs of the public.’

Philip Hammond unveiled plans which will see family doctors treating the less seriously ill in up to 100 casualty departments

Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said: ‘We feel that the best place for GPs is working with patients in their communities to provide high quality general practice and the money just announced for new triage systems in emergency departments would achieve more if most was spent shoring up general practice so we can deliver more care and services.’ 

Research last April found that setting up GP services inside A&E did in fact increase demand – and may also cost more money. Doctors from Sheffield Children’s Hospital concluded that the schemes were ‘expensive and disruptive’.

Surgeries across England are severely understaffed as rising numbers of GPs are retiring or quitting, but not being replaced.

The Government has promised to hire an extra 5,000 full-time family doctors by 2020/21. Many GPs may also prefer doing shifts in A&E as opposed to working full-time in surgeries as hours might be more flexible and hourly rates higher.

But in January, Health Secretary Jeremy Hunt claimed that up to a third of patients arriving at A&E had only minor illnesses.

However, senior doctors say many of those include worried parents with sick children, who may have meningitis or sepsis.