There has been a lot of recent interest in the new requirement for a named GP for patients aged 75 and over, which is a requisite for practices in England from April 2014.
This was part of the GMS contract changes for 2014/15 agreed between the BMA GPs’ committee and NHS Employers. It was a key policy championed by the health secretary and welcomed by large sections of the press, although to many GPs it appeared to be very similar to work they were already carrying out.
What will it involve?
But what in practice will it actually mean for patients and the GPs who will need to deliver this ‘new’ service? In reality, in a lot of practices patients already have a ‘usual doctor’ arrangement, and registration with a named GP was the regulatory norm before the introduction of the new contract in 2004.
There is already a contractual regulation in place to offer newly-registered patients a choice of their preferred named healthcare professional. So, in many cases, this change will formalise or build upon work GPs have been doing for years.
The responsibilities of the named GP, as set out in the contract agreement for 2014/15 are to:
- Take lead responsibility for ensuring all appropriate services required under the contract with the practice are delivered to the patient.
- Where required, based on the professional judgement of the named GP, work with relevant associated health and social care professionals to deliver a multidisciplinary care package that meets the needs of the patient.
- Ensure the physical and psychological needs of the patient are recognised and responded to by the relevant clinician/s in the practice.
- Ensure the patient has access to a health check, if requested.
The key point to remember is that this role is one of oversight and co-ordination. The requirements were agreed to reassure patients aged 75 and over that they have one GP within the practice who is responsible for ensuring this work is carried out on their behalf. It does not require the named GP to be personally available for daily contact and care.
It is largely for practices to decide how to allocate named GPs to patients and inform patients of the identity of their named GP. Practices may want to allocate GPs to patients based on who each patient’s regular GP is, or whether the patient has a condition that requires the expertise of a particular GP. However practices will have to make reasonable efforts to accommodate expressed patient preferences when assigning GPs to patients.
Practices will have to inform newly registered patients who their named GP is within 21 days of registration, and existing patients by 30 June 2014. Patients can be informed by the means that the practice deems most appropriate, including for example a note with a repeat prescription. There is a template letter available for practices to use on our website (and attached here, right) should they wish to write to their patients.
This change should not be confused with the quite separate ‘named accountable GP’ role in the avoiding unplanned admissions enhanced service, which is based upon a care planning approach to a register of vulnerable older people at risk of hospital admissions.
Ultimately if you have any questions, get in touch with the BMA.
- Dr Beth McCarron Nash is a GPC negotiator.