GPs are at the heart of NHS reforms
The changes will give GPs the lead role in care plans for their local communities but they will be under huge financial pressure and that’s a cause of concern.
According to a recent poll for the BBC, 83% of GPs thought there would be an increase in treatment ‘rationing’ and only 12% believed that patients would see a ‘noticeable’ improvement.
The 'R' word
Treatment rationing is nothing new – the NHS has always had to consider how resources should be shared, so medical treatment is provided according to need rather than demand. This means some patients may have to wait until their condition worsens before becoming eligible for treatment. The concern now is that the criteria for eligibility may become more stringent. Indeed, the following guidance currently given by one Primary Care Trust on hip and knee replacements shows that hospital treatment could be a ‘last resort’.
‘Patients should be referred for consideration of total joint replacement when all conservative means have failed to alleviate the patient’s pain and disability, which should be significantly interfering with their activities of daily living and their ability to sleep. Referral for specialist assessment should only be considered if the patient has:
• moderate to severe pain not adequately relieved by an extended course of nonsurgical treatment
• AND clinically significant functional limitation resulting in diminished quality of life.’
An unclear picture
Politicians and headline writers tend to focus on hospital waiting lists, infection control and similar targets. According to the King’s Fund’s early 2012 quarterly report, the NHS is generally meeting such targets at the moment. But almost half the GPs surveyed thought the NHS would be unable to continue meeting the 18-week target for routine treatments and a report from the Patients’ Association suggested that waiting times are already increasing for some elective surgery .
No crystal ball
So, there’s much uncertainty right now, but this much is guaranteed; doctors and other healthcare professionals will be looking very closely at the resources and services they have at their disposal and how to manage them come next April. And it's a pretty safe bet that waiting lists, treatment choices and postcode variations will be very much under the microscope.