The changing role of GP clinicians working in community hospitals.

David Seamark; Deborah Davidson; Helen Tucker; Angela Ellis-Paine; Jon Glasby

doi:10.3399/bjgp18X696713

Abstract

Background In 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.

Aim What models of medical care exist in English community hospitals today and what factors are driving changes?

Method Interviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.

Results Seventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.

Conclusion Multiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

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The changing role of GP clinicians working in community hospitals.

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