Dying Matters offers cautious welcome to frail patient announcement
In a move agreed by the British Medical Association and NHS England in talks over next year's GP contract, every person in England aged 75 or older will be assigned a named GP who will be personally accountable for their care around the clock.
Health Secretary Jeremy Hunt says that the move will reduce pressure on A&E services by ensuring elderly patients receive better and faster medical care in the community. Under the terms of the deal, doctors will carry out a trawl of their registers to identify the frailest 2% of patients. The aim is to create a much more proactive service whereby their needs are met much more quickly.
Out of five million emergency admissions last year, one-third were people over 75, and more than one million could have been avoided.
The Health Secretary said: "We are bringing back named GPs for the vulnerable elderly. This means proper family doctors, able to focus on giving elderly people the care they need and prevent unnecessary trips to hospital. Rigorous new inspections of GP surgeries will mean every local person will know whether they are getting the care they deserve. This is about fixing the long-term pressures on our A&E services, empowering hard-working doctors and improving care for those with the greatest need."
Commenting on the announcement, Simon Chapman, Director of Public and Parliamentary engagement for Dying Matters and the National Council for Palliative Care, said: "It is welcome news that people over 75 are to be offered more personal and co-ordinated care through their GPs. To make this work it's going to be essential that GPs initiate conversations with individual people about their wishes and needs for their care right through until the end of their life, so that these can be met.
"We need to remember though that of the 500,000 people who die each year in England and Wales about 150,000 are under the age of 75. The overwhelming majority of them will also need their own personal care-coordinator if they are to get the care they need in the place they want to be. We hear many stories from people at the end of life and their families who have experienced badly co-ordinated care. We only get one chance to get it right for them, and so this needs to be rolled out for everybody at the end of life as well as those over 75."
Dying Matters runs several initiatives aimed at boosting the confidence of GPs in having end of life conversations. These include:
- Two DVDs, 'Time to talk, Doc?' which gives advice to GPs on speaking to people with dementia about their end of life plans; and 'How Long Have I Got, Doc?', which advises GPs on breaking the news and continuing conversations with patients who do not have additional complications.
- The 2011 GP Pilot Project, which showed that with limited intervention it is possible to transform the confidence of GPs in talking about dying with patients, consequently measurably improving end of life care.