nhs managers.net dr clare gerada rcgp. without the right investment and infrastructure, general...
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nhsManagers.net
Dr Clare GeradaRCGP
Without the right investment and infrastructure, general practice will not be able to be an effective provider and facilitator of integrated care or provide
continuity
General practice as a driver of more cost effective care
In general practice, “generalism” makes little sense without
continuity of care
Fragmented care
Fragmentation results in providers caring for parts of a
patient rather than the
whole person
Fragmentation is at the
root of rising costs, poor quality of
care & rising health
inequalities
Continuity saves money
1% increase in proportion of patients able to see ‘their’ doctor associated with £20,000 cost
saving for average practice/yr
Chauhan M, Bankart JM, Labeit A, Baker R. Characteristics of general practices associated with numbers of elective admissions. Journal of Public Health. 2012; 34(4): 584–90.
Hill A, Freeman G. Promoting continuity of care in general practice. London: Royal College of General Practitioners, 2011.
www.rcgp.org.uk/policy/rcgp-policy-areas/~/media/Files/Policy/A-Z%20policy/RCGP_ Continuity_of_Care.ashx
Continuity of Care
• Improves health outcomes• Reduces costs• Improves patient (and clinician) experience• Reduces hospital admission • Improves quality of care • More personalised care• Earlier diagnosis• More effective care outside hospital• Better use of medicines• Better acceptance of self-limiting illness
Integrated care
• Best schemes are those led by GPs – backed by a team of other health and social care professionals with common objectives
• Review of literature found lower the input from GPs the worse the effectiveness of coordination of care and the number of referrals to the particular service concerned.
• To improve coordination of care need stronger links with secondary care – to improve transitions from hospital to home, and secure faster access to specialist knowledge.
Delivering Integrated care
Barriers to delivering effective general practice care
Larger GP practicesPart time workingAccess
Loss of GP lists
Multiplicity of providers
Increase work load
Balance of work
Increasing & Changing Workload
Workload
Between 1995 and 2008 the number of patient consultations
in primary care rose by 75%
The number of consultations per person per year rose
from 3.9 (1995) to 5.5 (2008)
Workforce
In a 12-month period from 2010-2011,
consultant numbers rose by 3.5% FTE
In the same period, GP numbers rose by just 0.2% FTE
Number of practice nurses vs total number of nurses 2009-2010
Change in average number of primary care consultations per patient per year, 2000-2008