GP practices should be working with complex patients to ‘actively avoid hospital admissions’ this winter, according to NHS England.
In a letter to ICBs and trusts, NHSE set out the actions necessary to ensure delivery of ‘safe, dignified and high-quality care’ this winter, which must be an ‘overriding priority’.
There was a particular focus on the winter vaccination campaign, with NHS England urging providers to ‘make every possible effort’ to boost vaccine uptake among patient-facing staff.
The letter also stressed the importance of promoting the respiratory syncytial virus (RSV) vaccine, which from this month practices began administering to over-75s and pregnant women as an essential service under the GP contract.
‘This is a year-round offer but its promotion ahead of winter by health professionals is vital, particularly to those at highest risk,’ NHSE said.
NHS England also urged local commissioners to take a ‘whole-system approach to managing winter demand’.
The letter asked ICBs to ‘ensure the proactive identification and management of people with complex needs and long-term conditions so care is optimised ahead of winter’.
‘Primary care and community services should be working with these patients to actively avoid hospital admissions,’ NHSE added.
These patients should also be offered ‘alternatives to hospital attendance’ as they may be ‘better served with a community response’.
NHS England told ICBs and trusts to continue delivering on the urgent care recovery plan, which was first published last year and was met with criticism from the BMA who warned that it would push workload onto already-overworked GPs.
The public spending watchdog later cast doubt on NHSE’s ability to deliver its recovery plan, stating what it would be a ‘significant challenge’ based on current trends.
In its letter this week, NHSE highlighted the ‘tight financial environment’ across the NHS, and recognised that despite improvements made so far, ‘far too many patients will face longer waits at certain points in the pathway than are acceptable’.
Last week, Pulse reported on concerns among GPs about lack of fridge space in practices to store the new RSV vaccine, which they said could create ‘huge problems’ for the rollout.
Proactive identification and management of people with complex needs and long-term conditions is not core GP work. Given there are no funds and currently practices should be working to rule with collective action this should be a non starter.
Sorry, no extra capacity. Where is the funding for such extra work?
This sort of thing boils Dr No’s piss. I usually admit people for fun. What do they want? Should we dispatch the no-hopers at home with opioids as we were instructed to in early 2020 instead?
Foxtrot oscar NHSE. Usual inept and increasingly irritating missal from a parrallel universe
GPs don’t admit patients to hospital. Hospital teams do after assessment.
We can’t prevent all bad outcomes, but GP’s can be hung out to dry for system faults
“Mia started complaining of a sore throat on 5 December and her parents took her to see a doctor three days later when she developed a temperature and severe headache.
Later that day, Mrs Glynn took her daughter back to the surgery concerned over her condition and the doctor called a hospital for a second opinion. The 37-year-old was advised to take Mia home as the hospital was full.“
https://www.bbc.co.uk/news/articles/c2kdd9q804qo
I practise medicine independently without any instructions from anyone. I will assess as required and refer anyone who I believe needs it.
One day it’s sepsis, next day it’s menopause, today admission avoidance, tomorrow death scrutiny.
Not taking any notice of this propaganda.
‘identification and management of people with complex needs and long-term conditions so care is optimised ahead of winter’
Like the old Admission Avoidance DES then? The one that was scrapped when it was shown to increase use of NHS resources without reducing admissions rates?
Great, can’t see a problem with that.
They might as well instruct patients not to get sick.
Presumably no one told them the story of King Canute trying to order the tidal waves to retreat?
If, on the other hand, they want to generously fund a significant extension of GP care based in the community in order to keep people out of hospitals, perhaps by increasing our share of NHS funding to 15%, I would be happy to consider their offer.
https://www.bbc.co.uk/news/articles/c2kdd9q804qo
Child dies after seeing GP Twice
How about..
Child dies after hospital refused admission … as it was full???
Who is medicolegally responsible
When the hospital declines an admission?
NHSE can instruct patients not to fall sick over this winter. problem solved.
What a dumb statement from NHSE, as if GP encourage patients to get admitted to hospital.
No winter pressure funding announced according to PCN/ICB when we asked yesterday.
NHSE closely followed by ICBs with their track record of continual failure over decades, vast numbers of failing anonymous managers with variable and on occasion dubious experiential and qualification backgrounds are simply unfit to manage the NHS .
NHSE & ICBs aided by PCNs & PCN CDs have failed patients via huge waiting lists, consistently destroying the morale of primary care /hospital staff , causing mass unemployment amongst highly trained GPs and junior (resident ) hospital doctors , increasing morbidity and mortality by leading emergency departments to beyond breaking point etc. etc.
The instruction should be for vast numbers of NHS England managers to resign as the initial step in the Labour stated aim to fix the NHS.
We wouldn’t be requesting The Post Office to advise on NHS IT systems and NHSE advice in parallel holds no weight.
Winter is coming so the NHSE barons play their usual game of “taunt the GP”.
The GP peasant archers respond cheerily with their two fingers. Pluck yew.
Again shows that those who work in ivory towers and have never seen a patient really have lost touch with reality on the ground. Ignore and work safely , admit , refer and prescribe for anyone that needs it. The NHS will not protet or care about you when you are in the dock.
I presume the BMA/GPC are already responding to the request for us to engage in ‘identification and management of people with complex needs and long-term conditions so care is optimised ahead of winter’ and are in urgent discussions with NHSE to price this new work, and are clear that we will not be able to start until agreement is reached?
In the real world that is what happens.
Look, GPs, you’ve got plenty of Morphine this year (unlike last winter during the supply crisis), and you have the phone numbers for the undertakers already. Why can’t you avoid admitting patients to hospitals?
I mean this stinks of people not realising how many people we see and don’t refer or send to A&E. We can’t do much about winter pressures and the increased worried well wanting a check up ‘to be on the safe side’ for their very minor sniffles and thus diverting some of the primary care suitable patients to A&E (because our capacity isn’t infinite!)
Now the plan is to try and stop little old Doris or Herbert from getting sick – any ideas on how we do that? When it’s winter and there’s bugs circulating?
And that’s before the lack of funding for this EXTRA service