Patients promised GP hours boost

Patients in Norfolk will get better care for less money under a new out-of-hours GP contract, health chiefs pledged last night - denying their promise was too good to be true.

Patients in Norfolk will get better care for less money under a new out-of-hours GP contract, health chiefs pledged last night - denying their promise was too good to be true.

The majority of patients classed as urgent cases will be assessed by a doctor when they first telephone the service, and more people will be visited in their own home, according to the plans.

Norfolk Primary Care Trust (PCT) said the new contract would also save £1.8m a year through better use of resources.

The winner of the three-year contract, worth £5.2m per annum, was revealed yesterday as the East of England Ambulance Service NHS Trust, which has run the service since 2004 under the banner Anglian Medical Care (AMC).

But one Norfolk MP said the deal “begged the question how will these savings be made” and queried whether the plan to cut costs while improving services was realistic.

The announcement broke a nine-day silence by the PCT over the identity of the winning bidder, chosen at a board meeting last Tuesday.

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Dr John Battersby, director of public health for the PCT said: “We are delighted to award the contract to the East of England Ambulance Service NHS Trust. Their proposal was of an extremely high quality and we are confident that they will provide the care out of hours that our patients need.”

Dr Battersby said the new three-year contract, which begins on August 20, would deliver care “certainly as good, probably better” than under the current contract.

Asked whether the promise of improved care on a reduced budget was too good to be true, he said: “I don't think it is. It just goes to show that by using staff in a more efficient way and making use of technology we can provide the same service at a lower cost.”

The majority of patients classed as urgent cases will now be triaged by a doctor when they first call, rather than having to wait for a call back from a doctor.

“If there are problems that can be dealt with by an emergency care practitioner (EPC) or a nurse rather than a doctor then they will be dealt with by those individuals,” said Dr Battersby.

The six out-of-hours medical centres across the county will remain, but fewer will stay open at night and when call volumes are low, with doctors, nurses and emergency care practitioners (EPCs) instead working from cars.

Dr Battersby said this would enable them to visit more patients at home, instead of sitting at base waiting for a call.

“The new service will operate from the same number of bases but the evidence we have collected is that there are periods during the night and at weekends when the number of calls coming into some bases is extremely low.

“That means there are sometimes highly qualified staff that are not particularly busy. We will be putting them into mobile units and using them in a more flexible way.”

The contract also provides the option of two afternoons' cover a week to allow GPs to undergo training courses, and patients who frequently see their GP because of a long-term condition or palliative care needs will also have care plans agreed.

Hayden Newton, interim chief executive of East of England Ambulance Service NHS Trust, said: “The trust is pleased and excited to be able to continue working with our excellent team within the out-of-hours service, and with our partners in Norfolk and Norwich University and Kings Lynn Hospital Trusts, to develop and implement a different way of providing, high quality care to the patients of Norfolk.

“It also gives us the opportunity to use the skills of our staff (EPCs) to deal with minor injury and illness nearer to people's homes and away from A&E.”

Norman Lamb, North Norfolk MP and Liberal Democrat health spokesman, said: “I'm relieved that the ambulance trust has won the contract because it's a good, well-run organisation.

“If the improvements they have disclosed are borne out in practice then that's certainly good news. The devil will be in the detail: if it's generally the case that more people will be visited at home at night by a doctor, nurse or paramedic, rather than having to travel to one of these centres, that's a positive step.

“But it begs the question how will these savings be made and whether that's realistic. The most important issue is whether people will be expected to travel longer distances to fewer locations or whether this will genuinely provide a better service to people in their own homes.