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Two CCGs set to rank GP practices based on A&E attendances

GP practices across one area of England will be ranked internally based on the number of patients on their list who attend A&E.

NHS Nene CCG and NHS Corby CCG plan to list the top 20 GP practices across Northampton that have the highest number of ‘frequent’ A&E users.

Once identified, the practices will be ‘supported in managing those patients proactively’, board papers revealed.

This support includes looking at including giving ‘appropriate’ patients their own personal health budget (PHB), after a Pulse investigation this year found that the two CCGs used the PHB scheme to give patient funds to have a holiday to rest and reconnect with family, an iRobot, and the construction of a summer house.

The A&E scheme forms part of a Primary Care Quality Contract, which the CCGs plan to roll out through their joint commissioning arrangement with NHS England.

A list of action points for the quality contract published ahead of an NHS Nene CCG board meeting this Tuesday included the note on frequent attenders.

It said: ’A&E frequent attenders: Identify the top 10 practices north and south (20 in total) with high intensity/frequency users and provide focussed support into those practices in managing those patients pro-actively. Utilise PHBs as a potential option for appropriate patients.’

Explaining the quality contract plans, the paper said the CCGs’ aim is for people to only go to hospital ’where there are no other community-based options for them’.

It said: ’Nene & Corby CCG wants to see an integrated, flexible and responsive primary care-led health system providing wider primary care at scale, with people only going to hospital where there are no other community-based options for them.

’Our aim, over the coming years, is to ensure a sustainable general practice in Northamptonshire… to facilitate the creation of a service that is able to provide high quality care by enabling it to manage the increasing demand for same day services, by working at scale with the wider health economy to ensure that NHS quality markers are met for all patients and to develop team working that supports the most frail and vulnerable patients.’

An NHS Nene CCG spokesperson told Northampton Chronicle: ’With high intensity or frequency users, we can provide focussed support into those practices, managing those patients pro-actively.’

It comes as CCGs were told in May this year to commission services that ensured that ’no patient should have to attend A&E as a walk in because they have been unable to secure an urgent appointment with a GP’.

 

Readers' comments (40)

  • Will those practices with those complex patients be given more resources to reflect the increased attendance at the GP also?

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  • ’no patient should have to attend A&E as a walk in because they have been unable to secure an urgent appointment with a GP’.

    Is that the same as:

    "no patient should choose to attend A&E as a walk in because the GP has correctly triaged their problem as non-urgent"?

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  • Perhaps if they invested more in primary care?

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  • Azeem Majeed

    There would need to be some adjustment for socio-economic characteristics as the strongest predictor of A & E attendance rates is usually the deprivation level of the population that the practice serves.

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  • Now let me guess the practices furthest from AE will have the lowest attendance rates. What a crude, stupid, GP bashing, steaming pile of p##.

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  • It should be subdivided into 1-preventable and 2- not preventable A&E attendance, then crunch the numbers and judge surgeries accordingly. As there should be a fine for attending A&E to get a prescription or a sick note. There also needs to be accountability for the mass mentality of a population. Its not always a surgeries falt that its population wants a 24/7 tesco-style healthcare.

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  • Does moving any MIU or A/E unit far away from their patients feature in their plans as that is the only thing that works.

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  • Bob Hodges

    A crude metric with too many confounding factors, betraying a huge lack of imagination from the CCG.

    Very poor.

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  • So let's suppose that those patients that have been given personal health budgets continue to attend A & E on a frequent basis and use up their budget. What's going to happen then?

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  • As far as I am aware once a patient has used their personal health budget the NHS will still continue to fund their care. Anyhow is an accident and emergency department going to routinely check every patient to see if they have a personal health budget? Would a hospital actually charge patients for and attendance if the budget had been spent? No I don't think so.

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