Doctors display ignorance over care in community

MOST family doctors remain confused and ignorant about local

arrangements for implementing the Government's community care shake-up next April, the British Medical Association warned yesterday.

The muddle is threatening to cause patients longer delays for hospital treatment as beds are blocked by frail elderly or other vulnerable people awaiting the guarantee of support in the community before they can be discharged, doctors' leaders said.

A survey of 330 GPs and 10 social services departments published in the BMA's News Review, found four out of five family doctors unaware of new mechanisms for collaboration between health and social care professionals.

With less than three months to go before the new system is introduced, nine out of ten GPs had no knowledge of any formal policy for discharging vulnerable hospital patients. A similar proportion felt the funding of the new arrangements would be inadequate.

From 1 April, local authorities assume responsibility for assessing the needs of vulnerable people, arranging appropriate services and funding them. The group comprises elderly frail, handicapped, mentally ill people, and those with long-term conditions such as alcohol dependency and HIV. The services range from provision of home helps for people recovering from hospital treatment to arranging nursing or residential accommodation.

Andrew Vallence-Owen, BMA under-secretary with responsibility for community care, said that although the situation may have improved since the survey was undertaken in November, there remained grounds for anxiety about local co-ordination.

He said: 'Beds could become blocked while we wait for social services to get organised, which in turn could lead to problems in admitting acutely-ill patients.'

David Blunkett, Labour's health spokesman, said the findings were further evidence that April was likely to herald 'the beginning of a nightmare rather than a new era for caring'.

Tim Yeo, Under-Secretary of State for Health, pointed out that his department had written to all GPs about the new arrangements. He added: 'It is up to health and local authorities and local GP representatives to make sure that individual GPs and other professionals know what changes are taking place in their areas.'

Social services departments' budgets would rise by 15 per cent in April, he said.