The Impact of Walk-in Centres and GP Co-operatives on Emergency Department Presentations

Crawford, J. et al. International Emergency Nursing | Published online: 18 April 2017

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Image source: Kake – Flickr // CC BY-NC-SA 2.0

Highlights:

  • Workload and resource pressures on EDs require the development of applicable minor illness and injury pathways.
  • Walk-in-centres have the potential to reduce ED workloads but more work is required to substantiate this pathway.
  • GP cooperatives can reduce ED workloads but further evidence is required to be confident of the efficacy of this care pathway.

Read the full abstract here

Total transformation of care and support

The Social Care Institute for Excellence has published Creating the five year forward view for social care: how transformed and integrated health and care could improve outcomes and cost-effectiveness.

This updated paper explores the potential for scaling up the most promising examples of care, support and community health services, initially using data from Birmingham City Council, modelling their outcomes and costs.  Originally published in November 2016, it has been updated to include additional models.

The report contains the following chapters:

Vision for transformed care: Re-shaping services around the needs and strengths of individuals, families and communities.

Key messages and summary: Outcomes can be improved, and costs reduced, if the sector scales up promising practice.

Case studies: Six models of care and their potential impact on costs and outcomes.

Models of care: Overview of promising practice that support transformative change in health and social care.

Conclusions and next steps

The paper is available to download here

Shifting the balance of care

Imison C, Curry N, Holder H, et al. Shifting the balance of care: great expectations.  March 2017 | Nuffield Trust.

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Moving care out of hospitals into the community can deliver holistic, patient-centred care closer to home.  In most cases however, it is unlikely to save money, according to a  report published today by The Nuffield Trust.

The report is based on a review of 27 schemes to reduce hospital activity, which included changes to urgent and emergency care pathways; speeding up discharge; managing ‘at risk’ groups; supported care at home; and cutting down on admissions.

Most of the initiatives demonstrated the potential to improve patient experience, and in some cases, outcomes. The evidence on cost savings was much less clear cut, partly because good economic evaluations have often not been carried out.

Several schemes did seem to be cost-effective in the right circumstances, but where schemes had been evaluated, most were cost neutral or were more expensive.

Download the full report here 

Report summary available here

Accelerating the adoption of person and community-centred approaches to health and care

A new relationship with people and communities: Actions for delivering Chapter 2 of the NHS Five Year Forward View | People and Communities Board

The report ‘A new relationship with people and communities’ outlines six high impact actions and related recommendations, supported by evidence and illustrated by examples. The actions address key pinch points in the NHS, where substantial progress can be made in the next 12 months, and where the actions can build energy around the broader agenda of changing the culture of healthcare. The annex – ‘Voluntary sector proposals’ – highlights approaches or interventions developed in the VCSE sector, which have been tested and evaluated and which have the potential for wider adoption.

Read the full overview here

Read the full report here

Patient safety in general practice could be ‘at risk’ – unless chronic shortage of GPs is turned around, with nearly 600 practices at risk of closure

RCGP | Published online: 18 September 2016

Patient safety in general practice across the UK could be ‘at risk’, if nothing is done to turn around the current chronic shortage of GPs, according to the Royal College of General Practitioners – with 594 practices across the UK at risk of closure by 2020 if more family doctors are not recruited.

In response, the RCGP is launching a ground-breaking new video and guide – which aim to help recruit thousands of additional foundation doctors, medical students and sixth form students into a career in general practice.

The RCGP says that as the population grows in size, and increases in age, there is a growing shortfall in the number of GPs – and estimates the total shortfall of GPs will stand at 9,940 by 2020.

The College says that unless drastic action is taken to ensure there are enough doctors in the workforce, thousands of patients could be forced to travel miles to their nearest GP practice or be left stranded with no family doctor at all.

Their launch comes against the backdrop of a health service that is faced with a population that is getting older and growing in size – with a resultant increase in the number of people suffering from chronic, long-term conditions and multiple-illnesses.

GPs and their teams now carry out around 1.3m consultations a day. Yet despite research stipulating that workload has increased by 16% over the last seven years, the College estimates that the number of full time equivalent GPs across the UK has actually fallen to 35,589 from 35,990 in 2013/14.

The RCGP believes that each nation of the UK will have a substantial shortfall in the number of its full time equivalent GPs by 2020, predicting that:

  • England will have a deficit of 8,371 GPs
  • Scotland will have a deficit of 830 GPs
  • Wales will have a deficit of 424 GPs, and
  • Northern Ireland will have a deficit of 316 GPs.

View the full resources list here