NHS shake up will see hospital consultants working in the community

As part of the huge shake up of the nations health service in Britain, hospital consultants are facing the prospect of government ministers forcing them to work out in the community as part of a crackdown on the "wasted hours" of outpatient appointments.

The Government's White Paper on the NHS, is expected to reveal details of a programme aimed at diverting billions of pounds away from hospitals and into GPs' surgeries and local health-care centres over the next 10 years.

Just one of the initiatives planned aims to reduce the accelerating number of outpatient appointments at hospitals currently at 45 million a year.

According to Health Secretary Patricia Hewitt, a pilot scheme will relocate all outpatient appointments for ear, nose and throat treatment, dermatology, orthopaedics, gynaecology, urology and general surgery, out of hospitals in certain areas over a 12-month period.

Senior hospital doctors will instead see patients in new "primary care centres" which are in effect larger GPs' surgeries and community hospitals.

It is the intention that patients will no longer have an unnecessary journey to major hospitals centres where they often wait for hours before a consultant sees them and help tackle the growing problem of missed appointments.

It seems that as many as six million outpatient appointments are missed every year because patients fail to turn up, costing the NHS an annual £575 million.

By these means the Department of Health estimates that the pilot scheme alone will move five million appointments away from hospitals.

If successful, the scheme will be introduced across England.

The strategy aims to shift resources into primary care, but there are suggestions that one of the biggest casualties of the spending shift will be the NHS's £12 billion hospital building programme in England.

According to Hewitt the White Paper is the product of a national consultation exercise that showed people wanted health services brought much more into local communities, and to have more control over their own health care.

She says people also want to be better supported in their health, independence and well-being, and to have convenient access to high-quality, cost-effective care.

Also in the pipeline are plans to offer "health MOTs" to every person in order to identify those at risk of illnesses such as heart disease before they develop.

According to the Department of Health the optional "life checks" will be offered to a person up to five times during their lifetime and will include a questionnaire and possibly blood pressure and blood tests and would also look at diet, smoking habits and weight.

The life check will take place at key stages in life and will also look at the medical history of a family.

Personal trainers will be available for some people which appears relevant at a time when the UK along with many Western countries, is struggling to control the growing problem of obesity.

A British Medical Association report last year said rising obesity levels had already led to an increase in children suffering from type II diabetes, a disease largely found in adults, and in future will cause more cases of heart disease.

At least a fifth of boys and a third of girls are expected to be obese by 2020 if current trends continue, says the report.