Variations in GP performance are leaving patients in some areas waiting weeks for an appointment, driving them to A&E instead. In some cases, patients are adding to the pressure by choosing A&E first when their GP could treat them. Some patients go to A&E as they have not registered with a GP surgery at all.
At a time when NHS budgets are under increasing pressure, the rising demand for A&E services comes at a cost - the council has calculated that A&E visits in the six months to March 2013 at Chelsea & Westminster, Imperial College and West Middlesex cost the public sector between £2.5 million and £10.5 million.
The clinical commissioners were called to give evidence to the council's Health Policy and Scrutiny Committee to explain how Hospital Trusts will plan ahead to manage admission numbers and costs with the reorganisation of A&E departments in North West London.
Cllr David Harvey, Chairman of the Committee said: "We need to take a tough love approach with both patients and GPs. There needs to be an active campaign to encourage patients to register with a GP and see their local surgery, not A&E, as their first port of call, which we can help to support. Hospitals need to think innovatively to stem the tide of non-urgent admissions - identifying regular over-users of A&E services; registering people for GPs on the spot; and sending non-urgent complaints to the back of the queue. On our part, we will continue our reablement programmes, which keep older people out of hospital through social care in the home.”
While recognising the strong current performance of many local hospitals, the Council urged commissioners to clamp down on a minority of GP practices.
"Critically, some GPs need to maximise their opening hours and appointment times to avoid people waiting weeks," said Cllr Harvey.
"If needless emergency admissions were dealt with by GPs spiralling costs would be slashed back but particularly those in real need would get the most immediate A&E attention. We need to make sure that people aren't being forgotten in the drive to cut costs and reach targets. We pressed the NHS on quality of care and how they will ensure that patients don't fall foul of target-driven process. Everyone, from social services to charities, and good neighbours too, can help ensure that the elderly and sick receive prompt medical help so that emergency admissions do not become necessary."