We’re very pleased to announce that we’ll be delivering a new piece of work in the next couple of months and, better still, it’s tackling a subject we’ve been investigating for a while: admissions avoidance.
The pilot project, part of My Healthcare, will be helping to tackle the thorny issue of patients repeatedly seeing their GP or going to A&E with issues that could be much better managed using social interventions.
Many of the GPs we know well tell us there is a small group of patients they see regularly for issues that don’t actually require medical support. This same group are also more likely to present at A&E.
For these patients, there is a clear need for a different kind of intervention; providing them with a service that addresses their needs directly and giving them the type of support they need.
The vast majority of CCG delivery plans, not just in Birmingham but across the country, include a need to reduce unnecessary admissions and free up GP time. So admissions avoidance is a national priority.
This is not about stopping people who genuinely need medical assistance from spending time with their GP or in hospital. This is about working with people who have largely social issues, or are mismanaging long term conditions.
The project that Gateway will be running includes two approaches, both of which have already been tried and tested – and proven to work – as part of Gateway’s current services:
1) Providing paraprofessional support for those with intensive needs
A proportion of the current “unnecessary” admissions are people with long term medical problems (such as mental health issues, or poorly-managed asthma or diabetes). Under the pilot scheme, the GP will refer them to Gateway where they’ll see a paraprofessional outreach worker. This will be someone who is experienced in working with vulnerable people, or those with complex needs. They will build up a supportive relationship with the client, addressing their needs directly and helping them to access a range of services that act as an alternative.
We know from running our Health Trainers and Pregnancy Outreach Services that this type of one-to-one support works; it builds resilience and can often start a “chain reaction” of beneficial lifestyle changes.
2) Providing befriender support for those with lower level needs
Many of the patients who are considered “unnecessary admissions” are lonely or socially isolated. They don’t need medical intervention but would benefit from social intervention and so, under the pilot scheme, the GP can refer them to Gateway for support. For this person, a befriender would be ideal.
Our volunteer befrienders provide emotional support and give the people they work with the time and space to talk. They can reintroduce people to their community and provide a bit of extra support going out. Again, we know that this type of help really works, because our experience – and our clients – tell us.
We know that intervention services have already been tested in other areas of the country and seem to work. But they tend to have a medical focus – community pharmacies, for example, or virtual wards – which we don’t believe is necessarily needed in these sorts of situations. It also makes them expensive.
If we can give patients with social needs an alternative to their GP, and resolve issues by giving them the time and type of attention they need, then GPs will get to spend valuable time with those who need their medical skills, and the NHS saves money.
Gateway’s new service will be part of the My Healthcare Prime Minister’s Challenge Fund pilot, an initiative developed by 23 Birmingham South Central CCG General Practices.Earlier this year the group bid for, and won, funding from the Prime Minister’s Challenge Fund to set up a programme that aims to improve services with a range of innovations. These include the provision of additional appointment times, the adoption of new digital tools and applications, and improved partnerships and service integration.
We’re really pleased to be involved in the My Healthcare project. The sort of service we’ll be providing, based on our years of experience, is something that we’ve been talking to CCGs about for a long time. My Healthcare feels like the perfect vehicle within which to try it out.