Exclusive: David Cameron's £50m package will fund 'bespoke' GP services for elderly patients

PM aims to shift care away from overworked A&E and back to the community

More than 1,000 GP surgeries will start offering appointments in the evening and at weekends, David Cameron will announce tomorrow. There are also schemes for consultations by Skype, and personalised care plans for the elderly.

The Prime Minister will unveil a £50m "Challenge Fund" package designed to stem anger over the failure of family doctors to provide round-the-clock appointments, with patients forced to book many weeks ahead or to compete with others for an emergency on-the-day consultation.

At the heart of the plan is a "bespoke service" for more than 750,000 elderly patients, which is designed to ease pressure on hospitals; a large proportion of beds are being taken up with over-75s, one of the fastest growing age groups in the population.

Because of a lack of accessible care at GP surgery level, elderly patients are often forced to attend A&E departments, and are then caught up in the system, often being discharged later than they should because there is no community aftercare service. The Independent on Sunday revealed last month that nearly one million people are waiting longer than four hours to be seen by a doctor at A&E. Andy Burnham, the Shadow Health Secretary, has warned that this log-jam has been created by cuts to local government social care budgets, meaning elderly patients who could have been treated at home for minor injuries and ailments are instead being admitted to A&E.

The IoS understands that Mr Cameron will unveil personalised care plans for the elderly, with doctors, practice nurses and other health-care professionals reviewing them on a regular basis to anticipate problems and prevent admission to A&E.

Elderly patients will be given prioritised appointments, and doctors will be required to make regular visits to nursing homes. More than six million people will be over 75 by the end of the next decade, and cases of illnesses such as dementia are increasing.

The £50m is being targeted at 1,000 surgeries that offer greater access to all patients, not only to elderly people, including appointments at weekends and between the hours of 8am and 8pm. There will be greater scope for consultations by email and Skype, while the Government will make it easier for people to move surgeries, order repeat prescriptions by email, and force GPs and hospitals to work more closely together to prevent readmission to A&E.

Mr Cameron will say that the priority must be to shift care from hospital to the home. But critics will question why this action has not been taken sooner. Last autumn, Labour predicted there would be an A&E crisis this winter, but Mr Cameron last week claimed that crisis had never materialised. However, much of England remained mild, and cold-related illnesses and injuries associated with falls on ice have been far fewer than in previous years.

At his party conference speech last October, the Prime Minister raised the prospect of appointments by Skype to ease pressure on GPs under the Challenge Fund plan.

Since the Labour government renegotiated GPs' contracts in 2004, family doctors have been free to opt out of providing appointments in the evening and at weekends. Coverage is patchy across the country, and a poll for GP magazine last year found that 80 per cent of family doctors rejected returning to providing out of hours appointments. The British Medical Association has opposed providing greater cover without more funding. The £50m to be announced tomorrow represents a tiny proportion of the NHS budget, and the 1,000 surgeries represent around one in eight in England, raising questions over how much cover the new funding will actually provide.

A Whitehall source said it was "crucial" to free up GPs so that they can spend more time with their sickest patients. "By becoming more proactive we hope to ease the pressure off GPs so they can focus on the older patients with more complex needs. The aim is to fundamentally shift care away from hospitals to people's homes where, with the right amount of support, they can better manage their conditions rather than be admitted to hospital."

At the Tory conference last year, Mr Cameron said: "Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life. We want to support GPs, to modernise their services so they can see patients from 8am to 8pm, seven days a week.

"We also want greater flexibility, so people can speak to their family doctor on the phone, send them an email or even speak to them on Skype," he added.

History of broken promises

2004

General Medical Services contract introduced. Surgeries, not GPs, have contracts with NHS. Allows GPs to opt out of out-of-hours services.

2006-07

Private companies begin running GP surgeries.

2009-10

Additional funding guaranteed for GP practices in deprived areas to tackle "health inequalities" between rich and poor.

2013

Some 211 regional Clinical Commissioning Groups (CCGs) set up to replace Primary Care Trusts. One GP per local surgery sits on CCG governing body that allocates funding, raising conflict-of-interest concerns. NHS Direct closed down after financial difficulties, replaced by NHS 111, run by private firms. Greater funding to deprived areas removed, NHS instead pours extra money into areas with high levels of elderly people. Plans to keep surgeries open seven days a week, 8am to 8pm, announced.

2014

The BMA warns funding cuts would remove guaranteed income for small practices, closing 98 rural surgeries. It says the bungled introduction of NHS 111 is likely to cost millions.

William McLennan and Joe Krishnan

Life and Style
ebookNow available in paperback
Sport
The Queen and the letter sent to Charlie
football
Arts and Entertainment
Eurovision Song Contest 2015
EurovisionGoogle marks the 2015 show
News
Two lesbians hold hands at a gay pride parade.
peopleIrish journalist shares moving story on day of referendum
Arts and Entertainment
<p>
<b>Kathryn Williams</b>
</p>
<p>
When I was supporting Ray La Montagne I was six months pregnant. He had been touring for a year and he was exhausted and full of the cold. I was feeling motherly, so I would leave presents for him and his band: Tunnock's Tea Cakes, cold remedies and proper tea. Ray seemed painfully shy. He hardly spoke, hardly looked at you in the face. I felt like a dick speaking to him, but said "hi" every day. </p>
<p>
He was being courted by the same record company who had signed me and subsequently let me go, and I wanted him to know that there were people around who didn't want anything from him. At the Shepherds Bush Empire in London, on the last night of the tour, Ray stopped in his set to thank me for doing the support. He said I was a really good songwriter and people should buy my stuff. I was taken aback and felt emotionally overwhelmed. Later that year, just before I had my boy Louis, I was l asleep in bed with Radio 4 on when Louis moved around in my belly and woke me up. Ray was doing a session on the World Service. </p>
<p>
I really believe that Louis recognised the music from the tour, and when I gave birth to him at home I played Ray's record as something that he would recognise to come into the world with. </p>
booksKathryn Williams explores the works and influences of Sylvia Plath
News
Liz Kendall played a key role in the introduction of the smoking ban
newsLiz Kendall: profile
Life and Style
techPatent specifies 'anthropomorphic device' to control media devices
Voices
The PM proposed 'commonsense restrictions' on migrant benefits
voicesAndrew Grice: Prime Minister can talk 'one nation Conservatism' but putting it into action will be tougher
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Guru Careers: Software Developer / C# Developer

    £40-50K: Guru Careers: We are seeking an experienced Software / C# Developer w...

    Guru Careers: Software Developer

    £35 - 40k + Benefits: Guru Careers: We are seeking a Software Developer (JavaS...

    SThree: Trainee Recruitment Consultant / Resourcer

    £18000 - £23000 per annum + Commission: SThree: As a Trainee Recruitment Consu...

    Ashdown Group: UI Developer - (UI, HTML, CSS, JavaScript, AngularJS)

    £25000 - £40000 per annum: Ashdown Group: UI Developer - (UI, JavaScript, HTML...

    Day In a Page

    Sun, sex and an anthropological study: One British academic's summer of hell in Magaluf

    Sun, sex and an anthropological study

    One academic’s summer of hell in Magaluf
    From Shakespeare to Rising Damp... to Vicious

    Frances de la Tour's 50-year triumph

    'Rising Damp' brought De la Tour such recognition that she could be forgiven if she'd never been able to move on. But at 70, she continues to flourish - and to beguile
    'That Whitsun, I was late getting away...'

    Ian McMillan on the Whitsun Weddings

    This weekend is Whitsun, and while the festival may no longer resonate, Larkin's best-loved poem, lives on - along with the train journey at the heart of it
    Kathryn Williams explores the works and influences of Sylvia Plath in a new light

    Songs from the bell jar

    Kathryn Williams explores the works and influences of Sylvia Plath
    How one man's day in high heels showed him that Cannes must change its 'no flats' policy

    One man's day in high heels

    ...showed him that Cannes must change its 'flats' policy
    Is a quiet crusade to reform executive pay bearing fruit?

    Is a quiet crusade to reform executive pay bearing fruit?

    Dominic Rossi of Fidelity says his pressure on business to control rewards is working. But why aren’t other fund managers helping?
    The King David Hotel gives precious work to Palestinians - unless peace talks are on

    King David Hotel: Palestinians not included

    The King David is special to Jerusalem. Nick Kochan checked in and discovered it has some special arrangements, too
    More people moving from Australia to New Zealand than in the other direction for first time in 24 years

    End of the Aussie brain drain

    More people moving from Australia to New Zealand than in the other direction for first time in 24 years
    Meditation is touted as a cure for mental instability but can it actually be bad for you?

    Can meditation be bad for you?

    Researching a mass murder, Dr Miguel Farias discovered that, far from bringing inner peace, meditation can leave devotees in pieces
    Eurovision 2015: Australians will be cheering on their first-ever entrant this Saturday

    Australia's first-ever Eurovision entrant

    Australia, a nation of kitsch-worshippers, has always loved the Eurovision Song Contest. Maggie Alderson says it'll fit in fine
    Letterman's final Late Show: Laughter, but no tears, as David takes his bow after 33 years

    Laughter, but no tears, as Letterman takes his bow after 33 years

    Veteran talkshow host steps down to plaudits from four presidents
    Ivor Novello Awards 2015: Hozier wins with anti-Catholic song 'Take Me To Church' as John Whittingdale leads praise for Black Sabbath

    Hozier's 'blasphemous' song takes Novello award

    Singer joins Ed Sheeran and Clean Bandit in celebration of the best in British and Irish music
    Tequila gold rush: The spirit has gone from a cheap shot to a multi-billion pound product

    Join the tequila gold rush

    The spirit has gone from a cheap shot to a multi-billion pound product
    12 best statement wallpapers

    12 best statement wallpapers

    Make an impact and transform a room with a conversation-starting pattern
    Paul Scholes column: Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?

    Paul Scholes column

    Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?