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DH 'rethink' of primary care role will help reduce pressure on A&E

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A 'rethink' of the role of primary care with the aim of preventing the need for emergency admissions, will be put in motion this year, the health secretary has pledged.

Addressing delegates at an Age UK conference last month, Jeremy Hunt said primary care must return to its 'root purpose' of looking after patients in the community and ensuring they don't become ill, rather than 'simply acting as a gateway' to hospitals.

He stated that the primary care system has become 'reactive when it needs to be proactive'.

Mr Hunt said plans would soon be announced for 'local pioneer sites' to lead the way on developing this model of care, with GPs supporting patients to manage their health.

An example is a GP-led multi-disciplinary team in Kent, which is already working with hospital matrons and using of teleheath. Since the start of the initiative, the team has reduced A&E attendances by 15 per cent and non-elective hospital admissions by 55 per cent among people with long-term conditions.

Mr Hunt stressed the need to develop similar services elsewhere and asserted that 'inaccessible primary care' was to blame for the rising pressure on hospital emergency departments, which he admitted was the 'biggest operational challenge facing the NHS right now'.

He said: 'One quarter of the population - that's 15 million people - have a long-term condition like diabetes, dementia or asthma. Although these conditions cannot be cured, they can be alleviated, treated and sometimes kept at bay.

'Too often people with long-term conditions are left to their own devices, without the help, care and guidance that local services should provide.'

Nurses attending RCN Congress in Liverpool last month also warned of a disconnect between the acute and community sectors. Jeanette Dunn a district nurse and chair of the Warwickshire and Coventry RCN Branch, said: 'We pick up the pieces of unsafe and inappropriate hospital discharges.'

Minister of state for care and support Norman Lamb will 'shortly' announce plans for local pioneer sites to lead the way on Mr Hunt's recommendations. NHS England is investigating system-wide operational incentives that must change to make this happen.

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