This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.theguardian.com/healthcare-network/2018/may/29/holding-risk-nhs-vital-role-played-gps
The article has changed 7 times. There is an RSS feed of changes available.
| Version 2 | Version 3 |
|---|---|
| ‘Holding the risk for the NHS’: the vital role played by GPs | ‘Holding the risk for the NHS’: the vital role played by GPs |
| (about 3 hours later) | |
| Although much has changed beyond recognition in the NHS over the past 70 years, one common strand has been the central role of the general practitioner as gatekeeper for nearly all other healthcare services, both in hospital and primary care. | Although much has changed beyond recognition in the NHS over the past 70 years, one common strand has been the central role of the general practitioner as gatekeeper for nearly all other healthcare services, both in hospital and primary care. |
| For most patients, GPs are the face of the NHS. According to NHS England, more than 5 million come through surgery doors each week. Just as importantly, most will return home or simply make a trip to the pharmacy afterwards. | For most patients, GPs are the face of the NHS. According to NHS England, more than 5 million come through surgery doors each week. Just as importantly, most will return home or simply make a trip to the pharmacy afterwards. |
| In fact a major part of the GP’s role is “holding the risk for the NHS,” says Prof Helen Stokes-Lampard, chair of the Royal College of GPs. So, for instance, a GP may refer one patient for a hip replacement much sooner than another, depending on their need and circumstances. “There is very sophisticated thinking going on when you make these decisions – you are weighing up so many factors.” | In fact a major part of the GP’s role is “holding the risk for the NHS,” says Prof Helen Stokes-Lampard, chair of the Royal College of GPs. So, for instance, a GP may refer one patient for a hip replacement much sooner than another, depending on their need and circumstances. “There is very sophisticated thinking going on when you make these decisions – you are weighing up so many factors.” |
| The gatekeeping role, which is widely admired around the world, actually pre-dates the founding of the NHS. But once the service became universal, everyone was expected to register with their family doctor. The resulting patient list is one of the foundation stones of the NHS system, says Dr Richard Vautrey, chair of the GPs’ committee at the British Medical Association. | The gatekeeping role, which is widely admired around the world, actually pre-dates the founding of the NHS. But once the service became universal, everyone was expected to register with their family doctor. The resulting patient list is one of the foundation stones of the NHS system, says Dr Richard Vautrey, chair of the GPs’ committee at the British Medical Association. |
| It means GPs can build up a relationship with the patient over many visits and possibly over many generations. “This enables continuity of care and holistic, family medicine,” Vautrey observes. | It means GPs can build up a relationship with the patient over many visits and possibly over many generations. “This enables continuity of care and holistic, family medicine,” Vautrey observes. |
| It also protects patients from unnecessary hospital visits and treatments. “We can help to interpret information and work in partnership with the patient to find the best course of action for a particular problem. Direct access to services can lead to the wrong treatment in the wrong place, as well as increased costs.” | It also protects patients from unnecessary hospital visits and treatments. “We can help to interpret information and work in partnership with the patient to find the best course of action for a particular problem. Direct access to services can lead to the wrong treatment in the wrong place, as well as increased costs.” |
| Current pressures on the NHS, and on GPs in particular, are clearly placing this approach under strain. The rapid increase in A&E attendances over recent years, for instance, reflects in part the growing problems in getting a GP appointment. At the same time, initiatives such as referral management centres are seeking to ration the number of referrals to secondary care. | Current pressures on the NHS, and on GPs in particular, are clearly placing this approach under strain. The rapid increase in A&E attendances over recent years, for instance, reflects in part the growing problems in getting a GP appointment. At the same time, initiatives such as referral management centres are seeking to ration the number of referrals to secondary care. |
| But for Vautrey, the biggest threat to the gatekeeping role could be online services. “The registered list depends on the fact that the majority don’t use the practice very often while a small number use it quite often,” he says. “If you shift the balance and practices lose those balancing patients, then you end up with an unstable system. There is a danger that something very precious will be lost.” | But for Vautrey, the biggest threat to the gatekeeping role could be online services. “The registered list depends on the fact that the majority don’t use the practice very often while a small number use it quite often,” he says. “If you shift the balance and practices lose those balancing patients, then you end up with an unstable system. There is a danger that something very precious will be lost.” |
| Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views | Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views |
| If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs | If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs |
| Healthcare Network | Healthcare Network |
| GPs and primary care | GPs and primary care |
| NHS | NHS |
| Health | Health |
| GPs | GPs |
| Doctors | Doctors |
| features | features |
| Share on Facebook | Share on Facebook |
| Share on Twitter | Share on Twitter |
| Share via Email | Share via Email |
| Share on LinkedIn | Share on LinkedIn |
| Share on Pinterest | Share on Pinterest |
| Share on Google+ | Share on Google+ |
| Share on WhatsApp | Share on WhatsApp |
| Share on Messenger | Share on Messenger |
| Reuse this content | Reuse this content |