Published: 17/11/2005 Volume 115 No. 5982 Page 9
The white paper on healthcare outside hospitals will set out the 'right incentive structures' to ensure GP practices start offering early morning and late evening appointments, health secretary Patricia Hewitt has vowed.
Ms Hewitt used her keynote speech to the NHS Alliance annual conference in Harrogate last week to trail key themes of the white paper, due 'at the turn of the year'.
She said looking at ways of getting more GP practices opening from 8am to 8pm would be key to the NHS understanding patients' needs, 'rather than them being expected to fit around the system'.
'This is not just a wish list, ' Ms Hewitt told delegates during a question and answer session following her speech. 'When we come to the white paper we will make sure we have the incentive structures in place to ensure it happens.' She added that the Department of Health would work with the British Medical Association and others to 'work out how we can use the [GP contract's] quality and outcomes framework' as an incentive structure, in addition to 'how we give patients more choice'.
'As we do that, we will see more practices responding to what patients want, ' she said.
Ms Hewitt said the white paper would also look at 'the possibility of dual registration, or single registration combined with dual relationships' so people could access practices near home and work, and offering greater choice so patients were not constrained by closed lists.
Mobile services could be one of the ways that demand for more services closer to home could be offered to patients, Ms Hewitt said.
Responding to a question about the future of small rural practices, Ms Hewitt said they 'need to make sure' that if they cannot offer a full range of services themselves, they look to other ways, such as using 'mobile services in a similar way as we have for cataracts in the acute sector.' . 'Radical' reform to improve the quality of primary care and commissioning should be considered, according to a King's Fund report.
The report says that although satisfaction with GPs remains high, reforms have failed to generate sufficient improvements.
The report calls for an opening up of the market and new groups and networks to strengthen specialist commissioning.
But it also says there need to be greater powers for primary care trusts to remove the contracts of GP practices who are not delivering a high enough standard of care.
BMA hits out over nurse prescribing
The British Medical Association has described as 'irresponsible and dangerous' government plans to give nurses and pharmacists greater prescribing powers.
Health secretary Patricia Hewitt told the Chief Nursing Officer's conference in London last week that all but controlled drugs would be available for prescription by nurses and pharmacists to free doctors' time.
'You will share my surprise that one or two doctors do not seem that pleased; we can trust nurses to take this new responsibility and use it wisely and well, ' she told nurse leaders.
But BMA consultant committee chair Dr Paul Miller said patients would 'suffer'.
'I would not have me or my family subject to anything other than the highest level of care and prescribing, which is that provided by a fully trained doctor.'
www. kingsfund. org. uk
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