Primary care leading the way

23 March 2016

On Wednesday, Slough CCG published plans to change how it delivers care to its patients. Under the proposals, a new primary care hub – ‘Slough Central’ – will provide non-urgent same-day appointments, as well as a range of specialist and diagnostic services. This moves beyond traditional GP services towards the “future that sees far more care delivered locally”, set out in the Five Year Forward View.

Such innovation is critical for the NHS to provide high-quality care while making the £22 billion savings efficiencies it has been tasked to achieve in 2020-21.

Providing extended services in primary care is more convenient for patients. Patients typically have to wait longer for appointments in secondary care. Moving services closer to home reduces admissions and unnecessary stayovers at hospital. This is shown by pioneering practices such as Lakeside Healthcare, a ‘super-practice’ covering over 100,000 patients in Northamptonshire. Its urgent care centre adjacent to a general practice, in which patients can access X-rays and blood tests within 15 minutes, reduces unnecessary hospital admissions by 30 percent.

Delivering diagnostic services locally also increases the chance that conditions will be detected early. For instance, Croydon GP federation working in partnership with InHealth reduced waiting times for ultrasound scanning and echocardiogram from five and six months respectively to two weeks. Early interventions result in higher-quality care for patients.

These primary-care led services can be delivered at a lower cost to the taxpayer. Croydon’s services reportedly saved £1.6 million from the reduction of follow-up appointments across the federation between February 2010 and January 2011. There is also considerable scope to increase back-office efficiency: NHS Alliance research found that processing information from hospitals was the second most burdensome task for practices; supporting patients to navigate the health system was fifth. It is not surprising, then, that international evidence supports the view that “healthcare systems configured around primary care produce healthier outcomes at lower cost”.

By reforming the way care is delivered, Slough will be joining best practice across the country. Modality Partnership, a super-practice based in Birmingham, provides its 70,000 patients quick access to dermatology, rheumatology, X-ray and urology services in primary care. Providers such as Lakeside and Modality are of sufficient scale to be able to invest in the equipment and skills necessary to provide extended services.

The Government has recognised the value of scaled providers offering extended services by outlining plans for a new voluntary GP contract for providers covering at least 30,000 patients. Reform will be publishing research next month setting out how new funding arrangements can incentivise high-quality care for patients at the lowest cost to the NHS.

 Thomas Sasse, Research Assistant, Reform

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