The Health service journal
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A slot system allocating a set number of outpatient orthopaedic appointments to general practices in North West Anglia HA means all patients referred are seen in eight weeks. The system has provoked criticism from GPs on the grounds that the burden of waiting lists has shifted onto them, and it limits access to services. The scheme has improved communication between GPs and orthopaedic consultants.
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A primary care-led NHS has enjoyed gains, but at significant cost. The policy has failed to address public health issues, inequalities and problems in access to services. The policy has caused divisiveness and is seen as exacerbating deep-rooted competitiveness between GPs and consultants. A new concept is needed to unite the aspirations of the whole NHS.