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Hospital-based GP practice begins attracting patients with long-term conditions

A GP practice has been set up within a hospital seeking to sign up only patients with five or more serious long-term conditions to its list.

‘Health 1000’, based at King George Hospital in Goodmayes, east London, has already begun advertising for patients, who will receive services from GPs, nurses, consultants, physiotherapists, geriatricians, occupational therapists and a social worker.

The idea behind the new practice is to reduce pressure on A&E department by offering personalised, responsive care to patients who are at risk of having to be admitted to hospital regularly.

It comes as NHS England last week set out its plans to attract GPs to work in its ‘new models of care’, which will combine primary and secondary care in a single organisation.

This scheme, which is run by GPs, has been funded by the PM’s ‘Challenge Fund’ to increase GP access, and has been commissioned by two CCGs in east London - NHS Barking and Dagenham CCG and NHS Havering and Redbridge CCG.

Patients who choose to join have to give up their existing GP practice in the process but will be able to access a ‘personal key worker’ to coordinate their care via telephone seven days a week, and be seen at home if more appropriate, the CCGs said.

The conditions which qualify patients from changing to Health 1000 include: coronary heart disease, high blood pressure, heart failure, stroke, diabetes, chronic obstructive pulmonary disease, dementia and depression.

Dr Jagan John, a local GP and director of Health 1000, said the service was ‘designed to meet all of a patient’s health and social care needs’ via a ‘coordinated approach…. tailored to their own individual needs and health and wellbeing goals’.

He added: ‘By working together to keep our patients healthy and out of hospital, we can also help to relieve the pressure on our local A&E departments.

‘Patients already registered with Health 1000 have said that they find it easier to access the care they need, when they need it. They have also said that they feel like they are receiving a more personal and supportive service.

He also told patients: ‘To join the service, you will need to transfer your care from your current GP practice to Health 1000. We know that this can be a big decision, so if you change your mind, you can transfer back at any time.’

Although similar to the Primary and Acute Care System (PACS) new model of care described in the NHS Five Year Forward View, the two CCGs are not new models of care ‘vanguard’ areas.

However, the CCG had its urgent and emergency care vanguard bid approved last month.

As part of the bid, the Barking and Dagenham, Havering and Redbridge ‘system resilience group’ has said it will create a simpler and more streamlined urgent care services because it thinks its 750,000 residents are ‘confused’ about the many and various urgent and emergency care services available to them.

 

Readers' comments (32)

  • This is interesting.

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  • I like this. immediate access to geriatrican who has immediate access to any investigation. Rather than us referring to them, waiting weeks if not months to be seen. I would even encourage some of my old boys and girls (and a few heart sinks) to join.

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  • I would like to know who the 'personal key workers' are that contact patients by phone. Are they GPs? Do these key workers have real time contact with hospital doctors? Is there extra funding above GMS / standard CCG hospital budget?

    Pulse can you find out more about their model.

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  • Wow, an idea that actually seems sensible.

    Enhanced care for the sickest patients, and it offloads the practice a little for delivering care to the rest of the patients.

    We'll see how this turns out...

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  • oh, and who will do the home visits? Hmmmmm......

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  • "oh, and who will do the home visits? Hmmmmm......"

    That's not their previous GP's problem. They're no longer registered.

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  • Funding should follow risk of illness, as these patients consult far more.

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  • That keyworker is probably the imam at the local mosque

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  • Unfair on surgeries that have exactly the same type of patients without extra funding within all their other patients. Surely it's well funded at present, otherwise why would anybody go for it. But what happens to these patients and surgeries once the PM challenge fund has dried up?

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  • hope it works, good luck ,

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