NHS leaders have directed hundreds of GP practices to find capacity for taking ‘urgent calls’ from the ambulance service to mitigate ‘unprecedented’ winter pressures.
NHS England’s East of England region wrote to all GP practices at the end of December to ‘ask for help’, warning that urgent and emergency care in the area is in a ‘critical’ state.
Dr David Brandon, interim primary care medical director for the region, recognised that general practice has become ‘somewhat numb to these requests’, but instructed GPs to take forward a series of actions.
He wrote: ‘No matter how hard this is to accommodate, please make capacity within your practice to take urgent calls from the ambulance service when they are on scene with a patient and need to speak with you.’
Dr Brandon indicated that the ‘considerable’ pressures at the moment are impacting the ability of ambulance crews to access their own internal clinical support and advice.
GP practices were urged to speak with ambulance crews if ‘there is an opportunity for the patient to be managed in primary care’.
The letter, seen by Pulse, continued: ‘Not only may this spare a patient a 10 hour wait outside the A&E department, but it allows the crew to move on to another case. It may also be that they can agree a management plan with you that avoids the need for a subsequent GP visit.’
GPs were also asked to ‘consider other routes of conveyance’ rather than by ambulance for patients who need to be admitted to hospital, and to ‘refresh’ their knowledge of infection prevention and control arrangements in order to reduce the spread of infection.
The NHS East of England team told GPs: ‘The number of people admitted to hospital with influenza has been doubling every 5-6 days, hospital bed occupancy across the region is at over 97%, staff sickness and ambulance handover delays have created a maelstrom of pressure that is unprecedented.’
Dr Brandon said it is important GP practices are kept up to date with these pressures so that they can ‘play [their] part’ and ‘hold a situational awareness’ when making clinical decisions.
The East of England region covers six ICBs with over 600 GP practices.
Last week, NHS England warned that flu cases had ‘continued to skyrocket’ nationally, with over 5,000 patients hospitalised with the virus at the end of 2024.
The UK Health Security Agency (UKHSA) had also issued ‘amber’ cold health alerts as temperatures dropped at the end of last week.
However, GPs told Pulse they were seeing ‘as expected’ levels of respiratory virus in the community, with pressures in line with previous years.
In May, Pulse reported on LMCs pushing back against ambulance crews who ‘inappropriately’ insist on speaking to a GP immediately when attending 999 calls.
Two LMCs put out guidance emphasising that practices ‘have no contractual obligation’ to give clinical advice to ambulance teams.
Quick to ‘instruct’ GPs for help.
Slow to come up with an enhanced service.
In fact a winter pressures enhanced service that has been around for a few years has been cancelled this year. And yet they are still asking for GPs to do uncontracted work.
When we are up against it in March, do you think ambulance crews will be willing to pop round to our housebound patients to complete their QOF work?
I hope that the relevant LMCs are informing GPs that they have no contractual requirement to provide this non-contracted and unfunded service, whilst also requesting NHS E who practices should send invoices to if they decide to provide the service. It is this approach to general practice – treating us as an all you can eat buffet – which has led to the current crisis, collective action, unsafe services, and reduction in health of the population.
Just say not. not in your contract. you won’t be breaking any rules. They need to fund a doctor for the ambulance crew to take advice and help from. also shared access to care records so they don’t have a ask GPs questions. simple.
‘instructed’ says it all. AS far as senior NHS management are concerned we are their servants.
Not funded and not safe.
We are not an emergency service. Taking emergency calls from ambulance services is a distraction from the patients in front of us and on our lit for the day.
Not doing it and not doable. Just say no.