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Super surgeries spell big changes for patients and pharma

Published on 31/03/05 at 01:26pm

GPs will be given the freedom to carry out services traditionally only available in hospitals as the government unveiled plans which could radically change primary care services.

The radical reorganisation is to be incentivised by the government, and could see the number of practices cut by 80% from almost 10,000 today to just 1,800 in a matter of years.

Health Secretary John Reid said he wants to grant "entrepreneurial" GPs the opportunity to broaden their scope and in doing so offer patients a wider choice of treatment at primary care level.

The new plans are part of the government's wider goal to combat inequalities in primary care services, with the Health Secretary admitting that some areas remained "under provided" with doctors.

The plans depend on GPs coming together to form much larger practices with at least 10 doctors in each, to create 'super surgeries' which will offer patients direct access to medical tests and treatment for conditions such as diabetes, asthma and arthritis which had previously only been available in hospitals.

The proposals already have the support of the NHS Alliance and the NHS Confederation.

"These changes will improve the health and well-being of every patient using the NHS and will strengthen the role of primary care itself," said Dr Michael Dixon, NHS Alliance chairman.

"Inequalities in the numbers of GPs across the country often mean that places with the greatest need have the lowest number of doctors. Every patient should have access to a GP when they need one."

But the reorganisation has not been universally welcomed. Graham Archard, vice-chairman of the Royal College of GPs said larger practices offered broader expertise and more flexible hours - but said there was no evidence that clinical care was improved.

"This demonstrates that the government has no idea what general practice is about," he told The Times newspaper.

"It is about continuity of care, developing relationships with patients and understanding where they are coming from. That depth of knowledge can only be harnessed after years of consultations with patients and their immediate and extended family."

The changes are certain to have a significant impact on the pharmaceutical industry's salesforces, which will in theory be able to access far more GPs at the same time compared to the current necessity of visiting a large number of smaller surgeries.

But the outcome is far from clear for the industry, and the reorganisation could accelerate the current trend for more and more doctors to refuse access to pharmaceutical sales reps.

Dr Reid announced the changes after the opening of a new NHS walk-in centre in Ilford, North East London, and denied claims they would spell the end of the family doctor.

"Contrary to some reports this is not the end of the family doctor. Quite the opposite," he said.

"We have 31,500 GPs and we are training more than ever before. We have more GP practices than ever before but because of greater demand than ever, on top of original GPs, we will be developing more services at community level which we were previously unable to do. If patients are getting blood testing and diabetes screening at the local level then we are developing services where doctors want it.

"It is vital that our family doctors remain at the forefront of change and innovation. Giving go-ahead GPs new freedoms not only allows us to get the basics right by providing equal access to a GP for all patients, it will also help deliver a wider range of services right on patients' doorsteps."

The government will help primary care trusts fund the start-up costs of services that expand into these areas. This expansion could lead to specialist arthritis and asthma clinics working across several PCTs.

The programme also aims to provide additional GPs and primary care professionals in areas where there is limited GP availability, with the first new doctors likely to be in place by 2006.

Radiographers, physiotherapists and community nurses could also be based in the centres, helping to make the centres a one-stop shop for many patients.

Health minister Melanie Johnson said that the new proposals offered a "huge attraction" for patients, adding:"GPs want this coming together in one building.

GPs and healthcare professionals are being invited to work with the NHS to provide the increases in GP numbers and services, with around 40 PCTs indicating they are interested in taking part in the programme.

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