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GP practices asked to 'proactively' visit vulnerable patients over winter

GPs have been asked to provide thousands more appointments and ‘proactive’ visits to vulnerable patients, under CCG plans to ease the pressure on A&E departments this winter.

Pulse has learnt that three CCGs in Leeds are all planning to commission additional services from GPs and out-of-hours services over the winter break in a bid to head off any crisis in emergency care.

The proposals from NHS Leeds North CCG, NHS Leeds South and East CCG and NHS Leeds West will see GP practices providing thousands more appointments over the Christmas and New Year period.

The proposals come amid a major focus on how greater access to GPs can ease the pressure on A&E departments. A recent major NHS England review into urgent care suggested that GPs should offer more same-day phone consultations to reduce the burden on ‘creaking’ emergency services.

NHS Leeds North CCG is proposing to commission its member practices to identify patients at risk of hospital admission and put in place an emergency care plan which will support carers and relatives during the winter period. Local out-of-hours services will also provide weekend and evening GP clinics.

NHS Leeds South and East CCG is asking practices to open on the Saturday between Christmas and New Year for the urgent care needs of registered patients and patients registered with other GP practices in the same locality.

A CCG spokesperson said: ‘For the period covering 27 and 28 December we expect an additional 420 appointments will be available.’

Leeds West CCG say its scheme to offer an enhanced service incentivising practices to plan and manage demand from 1 December to 28 February has been ‘well received’.

In a statement, the CCG said: ‘We estimate that the scheme will generate an additional 8,513 appointments in the three months from 1 December 2013 to 28 February 2014. Appointments, which will either be with a GP or practice nurse, will consist of pre-bookable and on-the-day appointments as well as proactive visits to support vulnerable patients both housebound or in care homes. The cost to the CCG equates to 50p per patient.’

Dr Richard Vautrey, GPC deputy chair and assistant medical secretary of Leeds LMC, welcomed the additional funding for GP practices.

He said: ‘These models show there’s not one easy solution to winter pressures and it’s good that all the CCGs are investing additional resource in general practice this winter as all practices in the city need support.’

‘It’s not agreed between the CCGs - it’s in the nature of independence of CCGs that they can make decisions based on local conditions.’

‘It will be interesting to see which approach works best at the end of the winter.’

The CCGs in Leeds are also working together on a public information campaign throughout the winter period called ‘Is A&E the best place for me?’. The campaign includes a dedicated microsite, a push on social media, advertising on buses and a range of printed information materials distributed throughout the city.

All three strategies for the Leeds CCG will have impact assessments performed after the event to see what difference these strategies have had upon the Leeds health economy.

Readers' comments (31)

  • Excellent. I can dust off my crystal ball.

    Obviously if I visit someone and they're okay today, it means they will be okay in the future and they definitely won't pick up something hours/days after I leave.

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  • Of course! Because at this time of year we have nothing else to do as it goes so quiet. I mean I often sit here gazing at my navel wishing there was something I could do to be more proactive..... NOT!!!

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  • No GP would have thought up this idea. The return on time invested will be negligible. Here, I have another one............
    Why don't Trauma consultants "pro-actively" visit RTA patients the day before the RTA occurs??
    Yep, Genius idea....should have been a top manager

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  • the headline is totally wrong
    from what has been written above it seems that more GP appointments will be available and capacity to do home visits will be increased. This does not mean that a GP has to go and visit all the vulnerable pts.

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  • And I suspect the outcome of the review will be that more patients will have had the opportunity to see their GP for trivial bull*hit and it will have no impact on AE attendance or admission rates.

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  • POLITICIAN : - " I have explained to GP's how they should be doing their job and how they can help hard working real doctors in A+E with the winter crisis.
    POLITICIAN :- " Feckless useless GP's . I told them what to do and they couldn't be bothered . It's all their fault and nothing to do with closing A+E departments.

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  • @ above.
    Elderly patients rarely consult their GPs for "bull*hit".A few more visits to the most vulnerable in our society isn't exactly going to do us any harm and may even save a few lives.We shouldn't always be demanding a pound of flesh.It's no wonder we're portrayed as Shylock's in the media

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  • >A few more visits to the most vulnerable in our society isn't exactly going to do us any harm

    What a totally stupid comment. Which of the currently well patients would you choose to visit? And how many surgery appointments would you cancel to do this. Visiting people trying to predict who is going to get ill is ridiculous.

    And you might care about how you are perceived, many of us aren't. We're satisfied with delivering quality care within the constraints we work in. I'm not going to waste my time and taxpayers' money just so I can be popular.

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  • Vinci Ho

    (1) If this story is exactly how it was reported here , one would say any new 'money investment ' into general practice is welcome. Question is whether there is enough manpower to provide these extra appointments. Presumably many practices are already well stretched during the normal five days. It will be more interesting to actually hear the stories of individual practices in Leeds.
    (2) Otherwise , it will mean giving the extra money to local OOH provider(s) to provide these appointments. Creating some more job opportunities, why not?
    (3) A care plan is only a good idea if existing arrangement has been 'chaotic' . Otherwise , it is another jargon to respond to politics
    (4) Proactive visit ?? Is it evidence based? OK , you are trying to do a pilot . But is this really the right time to do one?
    (5) Whatever will happen in Leeds does not necessarily mean that it will apply to other regions or cities. It is goodwill of GPs who are willing to help A/E.Successful or unsuccessful , you hope the clinicians involved will not let politicians hijack the headlines and use that to impose 24/7 on general practice........

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  • There is no evidence visiting and care plans and med reviews and intermediate care teams keep people out of hospital - for some things it increases admissions.

    On the other hand continuity of care and good discharge planning does - that is secondary care has to take responsibility for it.

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