‘Open longer hours or pay for patients going to A&E’

Doctors in England could find themselves paying the price when patients who might have been treated in their surgery end up in accident and emergency departments.

An NHS review to be published this summer will propose giving GPs a new incentive to provide longer opening hours as a means of reducing pressure on casualty and minor injury departments.

A Department of Health spokesman said: "We commissioned NHS Employers and the NHS Confederation to undertake a piece of work looking into the issue of a tariff for walk-in centres, minor injuries units and temporary residents. This report has now been received and the department will consider its findings."

According to a report in the Health Service Journal, the NHS Confederation has recommended a system of "cross-charging" that would allow hospitals to invoice GP practices when their patients receive primary care services elsewhere. A similar system is used in New Zealand.

Each year some 14 million patients who are treated in A&E departments, walk-in centres and minor injury clinics do not require hospital admission. The annual cost to the NHS is £940 million.