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Another top-down rejig would be disastrous

The Royal College of GPs has grave concerns about Andy Burnham’s proposals to create hospital-led integrated care organisations.

His plans could destroy everything that is great and that our patients value about general practice and could lead to the demise of family doctoring as we know it.

Only yesterday he criticised the expensive and time-consuming top-down reorganisation of the NHS as a result of the Health and Social Care Act. Yet his proposals would be just as disruptive, causing even more upheaval for patients and distracting doctors and managers away from what really matters – delivering excellent patient care.

GPs want to work as part of wider clinical teams to ensure that the NHS can provide a single service to each patient, instead of the fragmented approach that too often is experienced by patients today. But it makes no sense for hospitals – organisations that provide acute, intermittent and specialist care – to lead on the delivery of person-centred, continuous and co-ordinated care.

UK general practice is the envy of the world. GPs are consistently rated the most trusted healthcare professionals in the NHS so we are obviously doing something right.

There are things we could do better and general practice – like all other parts of the NHS – needs to modernise. But it is critical that any changes must not sabotage the unique relationship we have with our patients and the way that we tailor services to our local populations.

The college is positive about integrated care. We are positive about working with colleagues right across the NHS. But the model that Andy Burnham is proposing simply will not work.

In our own manifesto – launched earlier this week – we have our own five tests for effective integrated care which will continue to put the patient at the centre of everything we do.

Proposed models of integrated care should:

– Ensure community-based services are led by community-based clinicians with a person-centred perspective.

– Underpin safe patient care by ensuring that GPs can continue to act as independent advocates for their patients, with the emphasis on the person not the institution.

– Avoid over-medicalisation and the perpetuation of clinical treatments that are over-reliant on the perspective of condition-specific specialists.

Proposed models of integrated care must not:

– Lead to major structural reorganisation

– Lead to the diversion of NHS funding to plug the social care gap.

At a time when general practice is heaving under the strain, the last thing we need is more organisational interference, that will destabilise the NHS, divert millions of pounds away from patient care and distract GPs from caring for patients.

We hope that all the political parties will heed our warnings, otherwise the consequences for our patients will be disastrous.

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