Patients are already benefitting from GPs starting to take a lead in designing local health services and a renewed focus on health outcomes.
Examples from around the country highlight that during the first year of emerging clinical commissioning groups redesigning services, patients are starting to experience improvements in quality of care.
These include clinical commissioning groups such as in Newcastle where the number of patients admitted to hospital with emergency respiratory problems has decreased by 70 per cent. And in Bedfordshire a team has been set up to deal with emergency calls from care homes, helping reduce hospital visits by 40 per cent. A group in Wigan has redesigned stroke services, cutting the average hospital stay for patients from 56 days to 12 days.
After a decade of rising emergency hospital admissions, 2011 saw the first year on year decline. This has been achieved at the same time as a growing number of GPs have started to play a more central role in choosing the most appropriate care for their patients. It also coincides with a renewed focus on improving outcomes rather than targets, giving the NHS greater freedom to focus on delivering the very best care for patients.
The figures show a 0.5% decline in emergency hospital admissions, compared to 4.6% and 3.3% increases in 2009 and 2010 respectively. Between 2001 and 2010 there was a 36% increase in emergency admissions, which has put sustained pressure on doctors and nurses.
The Prime Minister will today host a roundtable discussion with Royal College leaders, Clinical Commissioning Group chairs and other stakeholders. In addition, Health Secretary Andrew Lansley has written to all clinical commissioning groups outlining the key role they will play in the future health service.
Andrew Lansley said:
“We have always been clear that patients will benefit from putting power in the hands of frontline doctors and nurses. By starting to do just that, we are seeing a positive change in the way our NHS is responding to rising pressures. Patients are being treated in more convenient places, pressure on hospitals is reducing, and we are safeguarding the NHS for future generations.”
Paul Bowen, a GP and clinical commissioning group lead in Cheshire, said:
“Instead of someone else making decisions about what patients need, my clinical staff and I will work with patients, giving them a wider choice of where, when and how they receive their healthcare.
“Putting doctors and nurses in the driving seat for the first time to commission services for patients is essential if we want to boost the quality of services for patients, but also deliver the efficiency savings needed in the NHS.”
Examples of clinicians in clinical commissioning groups starting to move away from the hospital-based system and deliver better care for their patients in the community include:
• The Dartford, Gravesham & Swanley Clinical Commissioning Group’s focus on preventing hospital admissions saw a 33% reduction in hospital attendances and admissions amongst care home patients over a six month period.
• In Nottingham, the clinical commissioning group has reduced emergency admissions by working with all GP practices in the area to provide as much information as possible to patients about the new 111 service.
• A clinical commissioning group in Barnet has set up a community gynaecologist, helping over 400 women a month get this treatment closer to home, not in hospital.
• A clinical commissioning group in Bedfordshire has set up a team to deal exclusively with care home emergency calls and arranged for vulnerable older people to be treated in their home, and made nearly a 40% reduction in hospital visits.
• Bath and North East Somerset Clinical Commissioning Group has developed a simple blood test for GPs to improve care for heart failure patients which will save the NHS locally up to £60,000 a year, and benefit on average 10 patients at every practice in the catchment area.
• A clinical commissioning group in Torbay has set up an innovative fitness and exercise programme that has resulted in around 60 per cent of the people who attended the pilot course losing 5-10 per cent of their body weight.
• A clinical commissioning group in Wigan has redesigned stroke services and reduced the average hospital stay for patients from 56 days to 12 days, reducing A&E waits and saving £700,000 per year.
Further case studies can be found on the Department of Health website.