GPs should not be given back direct responsibility for out of hours care, according to NHS England chair Sir Malcolm Grant.

Earlier in the year the health secretary indicated that GPs should become more involved in the running of evening and weekend care. Jeremy Hunt in part blamed the 2004 GP contract − which allowed and encouraged GP contractors to opt out of the services − for poor accident and emergency waiting time performance.

Asked whether he believed responsibility should be returned to GPs, Sir Malcolm told HSJ: “I think the past is sold. Many years have passed since the GP contract changed that. For GPs at the time it was a great relief.

“My wife is a GP and she was finding it actually really hard to cope in the old days with a large patient list, and being up all night and at weekends, albeit shared with [GP] partners. I think there are better ways of doing it than that.

“The question is what’s best for patients − continuity of care is the critical thing, and far better handling of medical records would be another way of providing high quality out of hours care.”

Sir Malcolm said general practice would be a priority for NHS England’s work on a 10 year strategy, which it launched last month.

He said: “I see GPs as an absolute fundamental of the English way of providing healthcare, but we need to help them. [We will] Look at ways of supporting them, simplifying what they do, relieving some of the burdens.

“It’s quite important for us to concentrate on general practice as a cornerstone of the system.”

Sir Malcolm said having a “vigorous debate” about a strategy for the future NHS was the major advantage of NHS England’s independence.

Asked if that work or Mr Hunt’s development of a plan for care of older people would take precedence, he said: “The vulnerable older people plan is really good and fits well with our Call to Action [on our strategy]. Our Call to Action we would say is a much bigger, much wider vision for the future of the NHS.”