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Integration between A&E and primary care can ease pressure

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Better access to primary care is critical to easing the pressure on A&E departments, states a report by Sir Bruce Keogh.

The report, Transforming Urgent and Emergency Care Services in England, outlines five recommendations that aim to increase the number of urgent cases treated in community services.

The report recommends providing faster and more consistent access to general practitioners, primary care and community services, such as local mental health teams and community nurses, to stop patients relying solely on A&E for urgent health problems.

Improved communication between hospital and community services can build a network of care where advice and expertise can be shared, says the report.

Sir Keogh recommends that an enhanced NHS 111 service is provided to allow patients to speak directly to a nurse, doctor or other healthcare professional about any concerns that they may have. People should also be able to book direct appointments or a call back from a GP.

Ambulances can be turned into mobile emergency units by extending paramedic training and supporting them with GPs and specialists, so that they are capable of dealing with people at the scene, and can avoidtaking them into hospital.

The report also recommends providing support for people to self-care.

Dr Clare Gerada, the chair of the RCGP, said that it was encouraging to see a report that planned the future of urgent and emergency services and which didn't blame GPs.

'This report proposes a substantial overhaul of the way patients will access urgent care services and GPs are keen to play their part and clear up the confusion that many patients face about where to go when they need urgent care.'

Dr Michelle Drage, chief executive of Londonwide LMCs, says that unless more funding and resources are directed towards primary care, they will be unable to 'mop up' the fallout of A&E services.

'This report has taken a problem and is looking at it the wrong way round. We need to work out how to support community services to manage the demands better.'

The report estimates that the bigger changes will take around three to five years to implement, but significant progress towards some of changes are expected in the next six months.

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