----- Original Message -----
Sent: Thursday, April 01, 2004 9:51
AM
Subject: Re: GP in A/E[Scanned]
I believe that the fundamental issue is whether
"emergency" GP OOH is sufficiently similar daytime "emergency" primary care
such the same competencies are required. I am concerned that as the
majority of GPs become daytime chronic disease managers their value to
out of hours care may be jeopardised by too infrequent exposure. If
"emergency" GP OOH defaults to non GPVTS doctors assisted by Emergency
Primary Care Practitioners there will need to be robust nationwide
triage criterea back to daytime Primary Care without being seen at thye point
of contact by the Emergency OOH team. If this is not in place there is a risk
of a drift of daytime primary care to the Emergency OOH team
because it will be much more convenient to a large proportion of patients who
misguidedly do not value continuity of care offered by daytime primary
care.
The other alternative would be to introduce a deterrent fee to PCTs /
LHBs or the patient if they opt to have non urgent primary care treated by the
Emergency OOH Team because they do not perceive that daytime primary care is
meeting their needs.
I would be very interested to opinions on
(1)
Is there a need for GPVTS trained doctors in Emergency OOH Primary Care or
does this need a different training programme.
(2) Are the current NHS
Direct Criterea for referral of enquiries back to daytime primary
adequate for use at the Emergency OOH Team Triage
point.
