How commissioning will affect your practice
North Bradford PCT has been operating practice-based commissioning for four years. All of its 12 practices are involved and the scheme covers outpatients, elective surgery, locality services and acute care.
Some 6,000 appointments a year that would have been handled by hospitals are now dealt with in primary care, including by 32 GPs with a special interest.
Before it set up the scheme, the PCT's analysis of urgent care revealed 10 per cent of acute admissions were caused by 189 patients and cost £1 million. Just 500 patients accounted for 20 per cent of acute admissions.
Trust chief executive Dr Ian Rutter, a GP in Shipley, said GPs realised hospital procedures they had regarded as 'free' cost a lot of money.
'When people realise costs are inappropriately locked in hospital beds we begin to see a more integrated approach to diagnostics and case management, because funds will allow us to do it,' he said.
Examples of new care pathways include:
·Urology referrals are triaged by GPs with a special interest and there is a cystoscopy service in primary care
·Musculoskeletal GPwSIs work with specialist physiotherapists to triage and treat patients, with referrals to orthopaedics reduced by more than 50 per cent
·ENT majority of patients managed by three GPwSIs
·Drugs misuse GPwSIs head up a community-based service in primary care
·Neurology most patients are managed in primary care
Patients typically wait two weeks to see a GPwSI.