Practice GPs asked to join hospital wards rounds

Nottinghamshire GPs have been asked by their CCG to set aside time to accompany hospital GPs on ward rounds and assist in discharging patients.

This comes as the two local hospital trusts, as well as the East Midlands ambulance service, are in 'very challenging conditions,' according to an email issued to Nottinghamshire GPs.

Local GPs have 'once again come forward' and supported with additional extended access hours, urgent GP appointments, and acute home visits, according to the letter from NHS Nottingham and Nottinghamshire CCG.

The CCG said that they were considering another option, that GPs might help by accompanying secondary care colleagues on their ward visits to facilitate the safe, early discharge of those patients who could go home. This arrangement has been used before, with GPs assisting secondary care colleagues on hospital ward rounds, and the CCG’s email said that both parties found it 'very helpful to combine their thinking’.

Local Pressures

Current pressures on health services in Nottingham are ‘extremely challenging’ and the system has been in OPEL 4, the highest alert level, for weeks. Many GPs, however, require "relief from their present obligations," and ward rounds are not work that would suit everyone, according to the email.

The CCG informed GPs that indemnification contracts could be drafted and that they would merely serve as an 'advisory' body – terms and payments would be in accordance with those already provided for equivalent shifts in the out of hours/primary care 24 services.

'There is a big issue in general practice with excessive workload and a scarcity of physicians,' a local GP said in response to the email. 'On top of that, there are long outpatient lines, delayed treatments, and a rising number of GP recommendations being turned down.'

The GP also acknowledged that hospitals are under strain owing to 'reduced inpatient beds and delayed discharges, mostly due to the breakdown of the social care system,' but added that 'these concerns pre-date the epidemic.'

‘So when a request comes in to support our hospital colleagues with discharges, you can imagine the negative reaction from grassroots GPs’.

'We have a joint obligation to care for our people,' Nottinghamshire LMC chief executive Michael Wright told Pulse, 'but GPs as a profession are already incredibly stretched, and patients are questioning why they can't receive the access they desire.' If not understood, it may appear that GPs have a lot of free time.'

Waiting times not met

Joe Lunn, assistant director of primary care commissioning in Nottinghamshire, told Nottinghamshire Live that the CCG was doing everything possible to help reduce the stresses on NHS services, especially over the Easter weekend.

As of Friday, April 8, there were 485 Covid patients in Nottinghamshire hospitals. While the virus was not the primary reason for the majority of those patients, it nevertheless adds to the pressures by requiring patients to be isolated.

According to the Royal College of Emergency Medicine (RCEM), 44 percent of patients had to wait more than four hours to be examined, treated, hospitalised, or released in the final week of March, compared to only 19 percent in the same week in 2019, before the pandemic began. As a consequence, several medical specialists claimed they'd never seen anything like it.

Earlier this month, a number of hospitals were rerouting patients throughout England due to Covid pressures and staff illness. And as part of a new pilot initiative, GPs stationed at the front entrance of a London A&E diverted people to reduce congestion on hospital departments in February.



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