The NHS budget is protected from cuts under the new government. But the rise in Emergency Admissions over the last few years threatens to use up all of the protection and more. And yet, until we invest in care outside of hospital, we can’t change this rise.
I have to declare an interest – well two actually.
I am business development manager for a GP surgery in North East England, and establishing a consortium of GPs to provide services outside hospital
I spend part of the week working at NHS Information Centre, where I have access to data on health care use (through the publicly available services of NHS Comparators
Government health policy for increasingly local decisions
This coalition government has made no secret of putting decision-making into the hands of GPs (General medical Practitioners), and this is a good thing. But it may not happen overnight (“David Nicholson doubts 2012 timescale for GP commissioning role”
GPs can help
GPs are generally the decision-makers.
GPs decide what care each individual patient should receive, what pathway they should follow.
They either create, or don’t create, alternative pathways for patients in the community which gives patients an opportunity to avoid hospital and stay in the community in their support network.
They either make it easy for patients to go to their own doctor, or they don’t; patients always choose the path of least resistance (cost to NHS of patient seeing GP around £18, cost just for attending hospital around £70, cost of treatment on top of this).
Out-of-Hours services (OOH) are a supreme case in point. In 2004, GPs relinquished responsibility for providing OOH services, because the Blair government believed that it could provide a better service, for less money, through private contracts. The result – patients turning up at A&E in their droves, and ultimately poor treatment and deaths (Penny Campbell 2006, David Gray 2009, Kirklees Report 2009).
We already have the tools to do something about this
UK’s Department of Health (DH) has established a formula for funding patient care, on the basis of GPs taking responsibility
Doctors already have formal networks between a locality’s GPs and hospital consultants, whether through learning networks or old training ties.
Doctors and other health professionals already meet, again formally and informally, to improve patient care; the networks are already established here. Health professionals together, working with social care professionals, are capable and usually willing to design new care pathways for patients, as long as it is worth while – the decisions are accepted by the Primary Care Trust (PCT).
What’s in it for PCTs?
World Class Commissioning assessment (WCC) has been the benchmark for a quality PCT for some years. A substantial part of the score is how well PCTs engage with healthcare professionals.
When WCC is replaced, it’s extremely likely to be with something broadly similar – if not measuring engagement, then at least measuring budgetary performance; this is dependent on GP engagement too.
So how do you engage with your local GPs?
Why would GPs, freed of their responsibility for everything for the last 6 years, want to take it all back again?
I’ve found that it takes a combination of specialist analysis and presentation skills, and specialist engagement skills, with a dose of credibility, to close the loop on GP engagement.
A lot of it is about presentation – what you present, how you prepare the data for presentation, and of course what you don’t present.
I believe we can help you there.
See also article on Technorati