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Worry over NHS care in community


Moving care from hospitals into the community - a key government policy - will not always save money and may put patient safety at risk, a report warns.

The National Primary Care and Development Centre report is described in Pulse magazine.

The analysis raised concerns over GPs doing minor surgery, and the cost of specialist care in the community.

The Department of Health said the public supported moves to provide care closer to home.

A white paper published in January last year set out plans to move care away from hospitals and into the community by encouraging GPs to carry out more specialist services.

Doctors 'at war'

Professor Martin Roland, director of the centre, analysed the proposals.

He told the BBC: "While there were good examples where care was moved and a high quality
was maintained - such as diabetes care - there were also examples of things such as minor surgery, where there were significant quality problems."
In general, the report also says moving minor surgery out to GPs had "little impact on
waiting times".

GP specialists had not always been properly monitored or integrated into local health services,
said Professor Rowland
Initiatives such as having specialist clinics in the community or putting diagnostic equipment into GPs' surgeries might not be cost-effective because patients could be dealt with
more efficiently in hospital, the report warned.




Professor Roland said: "It simply relates to the greater economies of scale that can be achieved in hospitals."

He added that, because GPs' salaries are higher than that of the average hospital doctor, asking them to carry out work in their practices could be more expensive.

The report showed there was not a "one size fits all" solution, he went on.