Family doctors are receiving extra training in Bradford in a pioneering scheme to cut hospital out-patient clinic waiting lists.

The district's new Primary Care Groups, which commission care for their residents, have brought in a variety of innovative schemes to reduce the numbers waiting more than 13 weeks for non-urgent appointments.

Hospital consultants in Bradford have worked closely with GPs to create GP specialists, who then run their own clinics and undertake a variety of minor operations and diagnostic procedures to reduce the pressure on the most senior hospital staff.

Dr Barbara Hakin, chairman of Bradford South and West Primary Care Group, said about a third of her area's 90 GPs were involved in the scheme, cutting waiting lists in specialities such as bone and joint problems, eye clinics, nerve diseases and general surgery.

Patients could see a specialist GP based in a surgery near their homes, saving them a trip to the hospital, said Dr Hakin. They could have minor operations such as the removal of cysts or warts, for example, and some GPs had the task of looking at their colleagues' referrals to a specialist to see if quicker care could be offered by a specialist family doctor. "GPs have always felt that what patients want most is a diagnosis. If they know what it is, it's not so bad waiting. Patients get a quicker diagnosis with some of the investigations we can do," she said.

"It's the co-operative working with the hospital consultants which has made this possible."

Lynnette Throp, chief executive of Bradford City Primary Care Group, said a scheme to cut down orthopaedic clinic waits, for patients with joint and bone problems, was already under way in the inner city area.

Specialist physiotherapists assess people waiting for appointments with consultants, and can start other treatment or refer them to a different speciality if that is more appropriate. Urgent cases can also be hurried through the system.

A study had shown that about a third of the area's patients waiting to see an orthopaedic consultant had back pain, which could often be managed better with physiotherapy, exercise or the pain management service.

"We commissioned this service from Bradford Hospitals Trust. Instead of using waiting list money to buy more clinic time or operations, it's trying to make a sustainable difference, and it's using a different way of doing things rather than doing more of the same things and getting more of the same problems," said Miss Throp.

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