Practices to spend 10 hours per week on personal care plans
By Nigel Praities
An average practice will have to spend 10 hours a week implementing the Government's pledge to provide personal care plans for all patients with long-term conditions, a Department of Health impact assessment reveals.
The report admits there are not enough GPs to run the flagship scheme and proposes enrolling nurses and healthcare assistants to plug the gap.
Lord Darzi's NHS Next Stage Review promised to offer care plans to all patients with a long-term condition by June 2010, with the Department of the Health announcing last year that GPs would be involved in carrying out the work.
But the new assessment makes clear the huge workload associated with the scheme, which will require care plans for around 1,440 patients at an average 6,000-patient practice.
If all patients take up the offer of a plan, it would use up an additional 4.9 hours a week of practice nurse time and 5.2 hours a week of healthcare assistant time.
The DH report estimates drawing up a plan will take 45 minutes for a patient with a QOF condition who is seen regularly, at a cost of around £19 per patient each year.
Plans for patients not covered by the QOF would take even longer, at an average of one hour 10 minutes each.
But if GPs were to run the programme the cost would sky rocket to more than £50 a time and would requite an extra 2,800 whole time equivalent GPs across the country.
Any such plans have, as a result, been ditched, despite fears healthcare assistants are not adequately trained for the job.
Dr Helen Hosker, a GPSI involved in planning elderly people's care in Manchester, said the plans were wholly unrealistic about the time and experience it took to produce care plans.
‘This is difficult stuff. It requires a lot of skill and to do it properly and takes time and effort. Healthcare assistants are not trained to do this and no-one has any spare capacity,' she said.
Dr Dermot Ryan, a GP in Loughborough, Leicestershire, said the plans had been inadequately thought out: ‘The costing is grossly underestimated. GPs will be involved whatever the initial document says. This is all about politics dressed up as pro-active health care.'
The report estimates the cost of the scheme as £253m over the next 10 years but claims it could save £846m in reduced hospital appointments.Nurses will have to spearhead personal care plans because of workload Nurses will have to spearhead personal care plans because of workload