Crisis-hit NHS to be given radical shake-up
A RADICAL series of reforms will bring in a “new era” for the crisis-hit NHS, it emerged last night.
In the shake-up, GPs will be parachuted into over-stretched A&E units to weed out time-wasters and ease the burden on the service.
Other measures will see pharmacists, nurses and paramedics take on roles traditionally taken by GPs.
Professor Keith Willett, who heads the NHS Urgent and Emergency Care Review, told the Sunday Express: “The current system is unsustainable. We have no choice but to change.”
The plan to station GPs in hospital emergency wards to filter out non-urgent cases was recently rubber-stamped by NHS England along with the other measures. The busiest hospitals will be the first to adopt it.
Chemists will be trained to diagnose, prescribe and treat patients and will have access to medical records with patients’ permission.
Doctors and nurses working for the NHS 111 telephone advice line will also be able to see medical records, again with permission. They will be called upon to divert callers to dentists, GPs and other health workers.
Paramedics are to have new training in diagnosis and will be able to prescribe drugs and refer patients to other health or social care workers.
People with serious and life threatening illnesses, such as strokes, heart attacks or major trauma, will be diverted away from casualty units to medical centres of excellence.
Those seeking general advice will be asked to search the NHS website for information on common conditions such as diabetes and asthma.
Professor Willett, who is a professor of trauma surgery at Oxford’s John Radcliffe Hospital, said: “We are not doing this to save money. This is about giving people the right care as close to home as possible.
“This Christmas has seen an unprecedented demand for all services which has gone totally off the scale. We could not have predicted it.
“These moves herald a new era for the health service.”
Professor Willett insisted the new system had been designed in direct response to patient demand.
“Across the board there has been relentless increase in NHS demand year on year,” he said. “We have an ageing population with more complex needs. We also have a ‘right now’ society.
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The current system is unsustainable. We have no choice but to change
“There has been a behaviour change in the way people use services. Patients do not want to wait for help.
"Many also do not want to trouble the NHS but feel they have no access to services other than A&E or dialling 999. We need to transform the NHS to satisfy this.”
A new “smart” NHS 111 service will mean staff can gain access to key details of a patient’s medical history and find out what drugs they are on and what they are allergic to.
Professor Willett said: “With a patient’s permission they will be able to access a limited summary of their medical history to make advice personalised. This will be better for many patients than going to A&E.”
He went on to describe in more detail the raft of reforms.
Paramedics would be given enhanced “See and Treat” (dealing with cases at the scene) and “Hear and Treat” (dealing with cases over the phone) training so fewer patients would need treatment in hospital.
He said: “Today paramedics are often seeing people who do not need to go to casualty units such as older people who have fallen and may be confused. Some of these patients are bouncing in and out of hospital.
Under the new system paramedics would also have access to their medical notes and would be able to treat them in their homes.
They would also be able to refer them to appropriate care such as a mental health nurse, GP or pharmacy.”
Pharmacists in emergency units would also receive enhanced training to prescribe drugs and send patients to other medical professionals.
In addition, nurses will be set up to deliver care in GP surgeries as an alternative to an A&E visit.
Patients will also be encouraged to use the NHS Choices website.
“Rather than phone a GP about a sore eye or holiday vaccinations, patients will be able to use the internet to find out how to deal with problems as they arise.
The website will also help people identify whether they do need to dial 111 or 999,” Professor Willett explained.
He hopes the moves will take the pressure off A&E units through which most of the five million people admitted to hospital every year are filtered. However, the measures have been criticised by health campaigners.
Kathryn Murphy, chief executive of the Patients’ Association, said: “This is a very different NHS to the one people have come to know.
We agree there needs to be change, however if patients are to be diverted from GPs and A&E then we need to have the right services available in the community to keep people safe and to look after them properly. At the moment this is not the case.”
Richard Paunt, director of policy at The Health Foundation charity, said: “The silver bullet for our health service is not to increase the range of other roles.
“There is no substitute for having a regular GP who knows your history, has all the information about you and can provide continuity of care, which is important.
“Doctors need a deep understanding of each patient to make good clinical decisions.”
Jane Cummings, chief nursing officer at NHS England, said: “This winter our local health services are responding to far and away the highest ever number of ambulance calls, A&E attendances and emergency admissions in the NHS’s history.
“That’s why the NHS, the Department of Health and local clinicians are all working together to plan carefully and expand services over the winter. This has included funding to provide extra beds, doctors and nurses to ensure patients receive the care they need as quickly possible.”
