Asked by the parliamentary Health Committee how GPs could relieve the pressure on overloaded A&E departments, Gerada said “underinvestment in primary care” was itself a critical problem.
Echoing a recent statement by NHS Confederation leader Mike Farrar, Gerada said “an integrated approach to urgent care” was the only way forward.
The Health Committee’s inquiry into emergency services follows statements by Health Secretary Jeremy Hunt that emergency services are taking up the load from ineffective GP practices.
Gerada warned: “We must make sure that we commission an integrated approach to urgent care. If you squeeze just one bit of the system, all you are doing is squeezing that problem to another part of the system.”
General practice was “under similar pressures” to emergency services, she argued. “We have seen an approximate 100% increase in our workload over the last decade and are seeing more and more long-term chronic disease.”
Trying to displace the pressure on A&E services into other areas of the NHS would “push the system to breaking point, which it already is in all honesty.”
Asked what GPs could do to reduce A&E attendance figures, Gerada answered: “I would turn it around. What can you do to help maintain the floodgate or the barrier that stops the rest of the NHS disintegrating?
“We see outside our practices now queues going down the road, which I haven’t seen since the flu epidemic a few years ago. We need to have a whole-system approach to start looking at the under-investment in primary care. We have 9% of the resources for 90% of the activity.”
Gerada also noted that blaming recent increases in A&E attendance figures on the 2004 GP contract, as Hunt did, was “lazy”.