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GPs working with paramedics helps shave £2.5m off Worcestershire urgent care bill

GPs working with paramedics has helped to save millions in avoided unnecessary A&E attendances in Worcestershire, the three local CCGs have said.

Since its launch in October 2012, the ‘GPs with ambulance’ scheme - a cooperation between the West Midlands Ambulance service, NHS South Worcestershire CCG, Wyre Forest CCG and Redditch and Bromsgrove CCG - has seen the ambulance service diverting patients to an on-call GP instead of A&E when they found this to be more appropriate. Since then, 2,900 emergency calls have been dealt with by GPs preventing over 2,300 A&E attendances, with an estimated saving of over £2.5 million, leaders of the project said.

Under the scheme, aimed at supporting the ambulance service and reducing the number of patients being admitted to hospital across Worcestershire, GPs are commissioned to work alongside paramedics and are either called out to an emergency by the ambulance control room, or by paramedics themselves, if they feel that a patient could be better cared for by a GP rather than in hospital. More than 50 GPs joined the scheme and are employed on a rota basis for eight hours a day, seven days a week between lunchtime and early evening - noted as the busiest time for ambulance crews.

Dr Nikki Burger, urgent care clinical lead for NHS South Worcestershire CCG said: ‘This scheme has gone from strength to strength since its launch. The pressures on emergency services are being felt all over the country and we have been really proud of the results that have been achieved in reducing numbers attending A&E.’

It comes as the Government wants GPs to help reduce pressure on A&E services by signing up to a £150m DES to cut unplanned admissions this financial year, although some experts have questioned whether the DES will fulfil its intended purpose.

Readers' comments (5)

  • I would love to know how they calculated the savings. Was there an actual reduction in the total number of people going to A+E - if so that is great.

    What is more likely is that those people attended by the GP service will be often marked as A+E transport prevented. In reality there will be a significant proportion that would not have actually gone to A+E, and the paramedics would leave at home instead. There would be some that would be discussed with/ sent to their own GP, but that is bypassed if there is another easier option.

    It may be similar to minor injury units, that do not significantly reduce costs.

    I hope that it did actually reduce attendances, but worry that there is a risk that the service creates work to fill it's role.

    The ultimate questions are:
    How much money has been saved off the bill from the hospital to the CCG? Is it more than or even close to 2.5 Million?
    Has the A+E been able to reduce staff numbers based on this reducing workload?
    etc etc?

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  • I agree. How much does it cost to pay these GPs to provide this cover. They are quite rightly going to cost a lot more than a junior doc in ED ...

    And let's withhold judgement til we see an actual verified reduction in attendance figures at the ED. Otherwise it's just a job creation scheme

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  • Bob Hodges

    Anon 1:32

    That's not the main issue.

    There are not enough GPs out there to 'General Practice' as things stand, and creating more 'jobs' mean that the post will remain vacant or cause an existing post to become vacant.

    In such ways do 'markets' develop - a true market aka a 'price discovery mechanism' would see posts where the GP's time was the most valuable having higher remuneration than other posts, and GPs migtaring to those jobs.

    What's more 'valauble' - GPs working with Ambulances to stop silly NHS111 pseudo-triage decisions resulting in Ambulance then Hospital, or active complex-care case managment and providing continuity for patientsin need (aka General Practice)?

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  • if you would like to know more about this service we have Dr Nikki Burger presenting on this at our free to attend 'Innovations in Practice' event on May 1 at King Power Stadium, Leicester. Free only for GP/CCG staff.

    You can register here..http://www.productiveprimarycare.co.uk/event-registration.aspx

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  • I have experienced this and on 4 occassions that patients ended up in A&E in a worse state than their original call. It would be a lot cheaper is the out of hours GP listened to the paramedics/ambulance crew on scene. Many of them have stated "Take them to A&E" we then call the "Admission Avoidance line" and they refer it to the out of hours GPs. That's what we wanted in the first place. GPs need to ride out with paramedics just to find our they're no just ambulance drivers

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